| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $75.86 | $741.31 | $3,090.30 |
Medical/Surgical Supplies and Devices - Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $75.86 | $741.31 | $3,090.30 |