| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $1,500.88 | $2,897.63 | $11,928.87 |
Medical/Surgical Supplies and Devices-Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $1,500.88 | $2,897.63 | $11,928.87 |