| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $13.84 | $14.41 | $19.87 | |
BCBS
| Professional | $23.00 | $23.00 | $23.00 | |
Medica
| Facility | $14.24 | $15.13 | $26.58 | |
Medica
| Professional | $15.72 | $26.68 | $108.59 |
Periodic Oral Evaluation - Established Patient
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $13.84 | $14.41 | $19.87 | |
BCBS
| Professional | $23.00 | $23.00 | $23.00 | |
Medica
| Facility | $14.24 | $15.13 | $26.58 | |
Medica
| Professional | $15.72 | $26.68 | $108.59 |