| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.28 | $89.28 | $89.28 | |
Aetna
| Professional | $89.28 | $89.28 | $126.90 | |
Molina
| Professional | $45.00 | $45.00 | $190.99 |
Prdontal Scaling&Root Planing 4/More Teeth-Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.28 | $89.28 | $89.28 | |
Aetna
| Professional | $89.28 | $89.28 | $126.90 | |
Molina
| Professional | $45.00 | $45.00 | $190.99 |