| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,466.85 | $4,466.85 | $4,466.85 |
Unlisted Procedure Dentoalveolar Structures
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,466.85 | $4,466.85 | $4,466.85 |