| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $101.40 | $111.06 | $232.00 | |
Moda Health
| Facility | $80.51 | $117.72 | $296.95 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |
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 | $111.06 | $232.00 | |
Moda Health
| Facility | $80.51 | $117.72 | $296.95 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |