| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.32 | $11.32 | $11.32 | |
Aetna
| Professional | $11.32 | $15.07 | $18.07 | |
Cigna
| Professional | $19.22 | $19.22 | $19.22 | |
United
| Professional | $28.00 | $28.00 | $60.00 |
Periodic Oral Evaluation - Established Patient
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.32 | $11.32 | $11.32 | |
Aetna
| Professional | $11.32 | $15.07 | $18.07 | |
Cigna
| Professional | $19.22 | $19.22 | $19.22 | |
United
| Professional | $28.00 | $28.00 | $60.00 |