| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $56.20 | $1,061.31 | $3,878.73 |
Medical/Surgical Supplies and Devices - Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $56.20 | $1,061.31 | $3,878.73 |