| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $23.99 | $39.81 | |
BCBS
| Professional | $34.67 | $34.67 | $34.67 | |
Medica
| Facility | $20.89 | $23.44 | $44.67 | |
Medica
| Professional | $24.55 | $45.71 | $158.49 |
Limited Oral Evaluation - Problem Focused
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $23.99 | $39.81 | |
BCBS
| Professional | $34.67 | $34.67 | $34.67 | |
Medica
| Facility | $20.89 | $23.44 | $44.67 | |
Medica
| Professional | $24.55 | $45.71 | $158.49 |