| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.06 | $22.06 | $22.06 | |
Aetna
| Professional | $21.52 | $28.57 | $39.22 |
Limited Oral Evaluation - Problem Focused
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.06 | $22.06 | $22.06 | |
Aetna
| Professional | $21.52 | $28.57 | $39.22 |