| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.60 | $119.60 | $119.60 | |
Aetna
| Professional | $108.63 | $119.60 | $122.03 |
Removal Of Impacted Tooth - Soft Tissue
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.60 | $119.60 | $119.60 | |
Aetna
| Professional | $108.63 | $119.60 | $122.03 |