| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.05 | $23.99 | $39.81 | |
Anthem BCBS
| Professional | $38.02 | $40.74 | $53.70 | |
Harvard Pilgrim
| Professional | $47.86 | $67.61 | $104.71 |
Limited Oral Evaluation - Problem Focused
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.05 | $23.99 | $39.81 | |
Anthem BCBS
| Professional | $38.02 | $40.74 | $53.70 | |
Harvard Pilgrim
| Professional | $47.86 | $67.61 | $104.71 |