| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.88 | $21.88 | $21.88 | |
Aetna
| Professional | $19.95 | $25.12 | $43.65 |
Limited Oral Evaluation - Problem Focused
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.88 | $21.88 | $21.88 | |
Aetna
| Professional | $19.95 | $25.12 | $43.65 |