| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.88 | $18.07 | $24.33 | |
Anthem BCBS
| Professional | $22.84 | $27.00 | $32.20 | |
Harvard Pilgrim
| Professional | $28.87 | $47.49 | $89.11 |
Periodic Oral Evaluation - Established Patient
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.88 | $18.07 | $24.33 | |
Anthem BCBS
| Professional | $22.84 | $27.00 | $32.20 | |
Harvard Pilgrim
| Professional | $28.87 | $47.49 | $89.11 |