| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.19 | $15.19 | $15.19 | |
Aetna
| Professional | $12.13 | $15.19 | $15.19 |
Intraoral - Occlusal Radiographic Image
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.19 | $15.19 | $15.19 | |
Aetna
| Professional | $12.13 | $15.19 | $15.19 |