| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,480.00 | $2,480.00 | $2,480.00 | |
Medcost
| Facility | $3,224.00 | $3,224.00 | $3,224.00 | |
Molina
| Professional | $2,041.80 | $2,041.80 | $2,143.89 |
Restorigin, 1 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,480.00 | $2,480.00 | $2,480.00 | |
Medcost
| Facility | $3,224.00 | $3,224.00 | $3,224.00 | |
Molina
| Professional | $2,041.80 | $2,041.80 | $2,143.89 |