| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $5,011.87 | $5,011.87 | $5,011.87 |
Medical/Surgical Supplies and Devices - Other Implants
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $5,011.87 | $5,011.87 | $5,011.87 |