| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $127.56 | $127.57 | $165.42 |
Removal Of Impacted Tooth - Soft Tissue
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $127.56 | $127.57 | $165.42 |