| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $19.05 | $25.12 | $34.67 | |
Medical Mutual of Ohio
| Facility | $19.05 | $19.05 | $25.12 |
Clinic-Dental Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $19.05 | $25.12 | $34.67 | |
Medical Mutual of Ohio
| Facility | $19.05 | $19.05 | $25.12 |