| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.28 | $28.28 | $28.28 | |
Aetna
| Professional | $20.92 | $28.28 | $34.81 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |
Comp Oral Evaluation - New/Established Patient
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.28 | $28.28 | $28.28 | |
Aetna
| Professional | $20.92 | $28.28 | $34.81 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |