| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.20 | $47.20 | $47.20 | |
Aetna
| Professional | $47.20 | $47.20 | $58.76 | |
BCBS
| Professional | $51.82 | $52.21 | $61.43 | |
Medica
| Facility | $40.17 | $47.20 | $141.60 |
Extraction Coronal Remnants-Primary Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.20 | $47.20 | $47.20 | |
Aetna
| Professional | $47.20 | $47.20 | $58.76 | |
BCBS
| Professional | $51.82 | $52.21 | $61.43 | |
Medica
| Facility | $40.17 | $47.20 | $141.60 |