| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $101.40 | $102.34 | $191.27 | |
Medica
| Facility | $102.34 | $116.29 | $221.43 | |
Medica
| Professional | $728.46 | $728.46 | $728.46 |
Extraction, Erupted Tooth Requiring Removal Of Bone And/Or Sectioning Of Tooth, And Including Elevation Of Mucoperiosteal Flap If Indicated
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $101.40 | $102.34 | $191.27 | |
Medica
| Facility | $102.34 | $116.29 | $221.43 | |
Medica
| Professional | $728.46 | $728.46 | $728.46 |