| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.07 | $13.07 | $13.07 | |
Aetna
| Professional | $12.90 | $16.93 | $23.41 |
Periodic Oral Evaluation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.07 | $13.07 | $13.07 | |
Aetna
| Professional | $12.90 | $16.93 | $23.41 |