| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $87.10 | $87.10 | $87.10 | |
Pacific Source
| Facility | $38.02 | $181.97 | $851.14 | |
Regence BlueShield
| Facility | $25.12 | $50.12 | $50.12 |
Clinic-Dental Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $87.10 | $87.10 | $87.10 | |
Pacific Source
| Facility | $38.02 | $181.97 | $851.14 | |
Regence BlueShield
| Facility | $25.12 | $50.12 | $50.12 |