| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,454.71 | $2,454.71 | $2,454.71 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 | |
Select Health
| Professional | $120.23 | $120.23 | $1,621.81 |
Restorigin, 1 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,454.71 | $2,454.71 | $2,454.71 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 | |
Select Health
| Professional | $120.23 | $120.23 | $1,621.81 |