| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.42 | $17.42 | $55.46 | |
Aetna
| Professional | $13.84 | $17.42 | $19.87 | |
Cigna
| Professional | $19.22 | $19.22 | $19.22 |
Periodic Oral Evaluation - Established Patient
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.42 | $17.42 | $55.46 | |
Aetna
| Professional | $13.84 | $17.42 | $19.87 | |
Cigna
| Professional | $19.22 | $19.22 | $19.22 |