| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.50 | $61.43 | $102.00 | |
Moda Health
| Facility | $45.63 | $65.12 | $130.56 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |
Extraction, Erupted Tooth Or Exposed Root (Elevation And/Or Forceps Removal)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.50 | $61.43 | $102.00 | |
Moda Health
| Facility | $45.63 | $65.12 | $130.56 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |