| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.56 | $29.56 | $29.56 | |
Aetna
| Professional | $20.35 | $28.57 | $32.49 | |
Cigna
| Professional | $32.29 | $32.29 | $32.29 |
Limited Oral Evaluation - Problem Focused
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.56 | $29.56 | $29.56 | |
Aetna
| Professional | $20.35 | $28.57 | $32.49 | |
Cigna
| Professional | $32.29 | $32.29 | $32.29 |