| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.27 | $48.27 | $48.27 | |
Aetna
| Professional | $47.80 | $48.27 | $90.99 |
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 | $48.27 | $48.27 | $48.27 | |
Aetna
| Professional | $47.80 | $48.27 | $90.99 |