| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $54.30 | $54.30 | $54.30 | |
BCBS
| Professional | $70.00 | $70.00 | $70.00 | |
Providence
| Facility | $72.73 | $72.73 | $72.73 | |
Providence
| Professional | $54.35 | $81.53 | $117.60 |
Extraction Coronal Remnants-Primary Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $54.30 | $54.30 | $54.30 | |
BCBS
| Professional | $70.00 | $70.00 | $70.00 | |
Providence
| Facility | $72.73 | $72.73 | $72.73 | |
Providence
| Professional | $54.35 | $81.53 | $117.60 |