| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.95 | $11.95 | $11.95 | |
Aetna
| Professional | $10.60 | $12.09 | $15.19 | |
Medica
| Facility | $11.95 | $12.73 | $21.61 | |
Medica
| Professional | $12.73 | $23.69 | $283.32 |
Intraoral - Occlusal Radiographic Image
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.95 | $11.95 | $11.95 | |
Aetna
| Professional | $10.60 | $12.09 | $15.19 | |
Medica
| Facility | $11.95 | $12.73 | $21.61 | |
Medica
| Professional | $12.73 | $23.69 | $283.32 |