| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $509.56 | $6,603.83 | $9,819.73 | |
Cigna
| Facility | $699.00 | $699.00 | $699.00 | |
Martin's Point
| Facility | $1,761.46 | $7,131.28 | $9,819.73 |
Unlisted Procedure Dentoalveolar Structures
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $509.56 | $6,603.83 | $9,819.73 | |
Cigna
| Facility | $699.00 | $699.00 | $699.00 | |
Martin's Point
| Facility | $1,761.46 | $7,131.28 | $9,819.73 |