| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.28 | $54.28 | $1,302.26 | |
Aetna
| Professional | $54.28 | $97.29 | $106.38 |
Prdontal Scaling&Root Planing 4/More Teeth-Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.28 | $54.28 | $1,302.26 | |
Aetna
| Professional | $54.28 | $97.29 | $106.38 |