| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $100.29 | $100.29 | $104.33 | |
Providence
| Facility | $170.14 | $170.14 | $170.14 | |
Providence
| Professional | $104.49 | $156.75 | $226.10 |
Periodontal Scaling And Root Planing - Four Or More Teeth Per Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $100.29 | $100.29 | $104.33 | |
Providence
| Facility | $170.14 | $170.14 | $170.14 | |
Providence
| Professional | $104.49 | $156.75 | $226.10 |