| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.20 | $51.20 | $51.20 | |
Aetna
| Professional | $51.20 | $51.20 | $102.00 | |
Molina
| Professional | $45.00 | $45.00 | $99.87 |
Extraction, Erupted Tooth Or Exposed Root (Elevation And/Or Forceps Removal)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.20 | $51.20 | $51.20 | |
Aetna
| Professional | $51.20 | $51.20 | $102.00 | |
Molina
| Professional | $45.00 | $45.00 | $99.87 |