| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.86 | $47.86 | $47.86 | |
Aetna
| Professional | $45.71 | $52.48 | $87.10 |
Full Mouth Debridement To Enable A Comprehensive Periodontal Evaluation And Diagnosis On A Subsequent Visit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.86 | $47.86 | $47.86 | |
Aetna
| Professional | $45.71 | $52.48 | $87.10 |