| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.07 | $58.07 | $58.07 | |
Aetna
| Professional | $47.24 | $58.07 | $58.07 | |
Anthem BCBS
| Professional | $71.40 | $84.00 | $84.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |
Extraction Coronal Remnants-Primary Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.07 | $58.07 | $58.07 | |
Aetna
| Professional | $47.24 | $58.07 | $58.07 | |
Anthem BCBS
| Professional | $71.40 | $84.00 | $84.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |