| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.09 | $86.09 | $86.09 | |
Aetna
| Professional | $85.19 | $95.55 | $100.29 | |
Molina
| Professional | $60.00 | $87.58 | $1,500.00 | |
Providence
| Facility | $87.14 | $103.85 | $130.15 |
Periodontal Scaling And Root Planing - Four Or More Teeth Per Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.09 | $86.09 | $86.09 | |
Aetna
| Professional | $85.19 | $95.55 | $100.29 | |
Molina
| Professional | $60.00 | $87.58 | $1,500.00 | |
Providence
| Facility | $87.14 | $103.85 | $130.15 |