| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.70 | $1,288.25 | $1,288.25 | |
Aetna
| Professional | $77.62 | $97.72 | $128.82 |
Periodontal Scaling And Root Planing - Four Or More Teeth Per Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.70 | $1,288.25 | $1,288.25 | |
Aetna
| Professional | $77.62 | $97.72 | $128.82 |