| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.65 | $128.82 | $204.17 | |
Anthem BCBS
| Professional | $162.18 | $177.83 | $234.42 | |
Harvard Pilgrim
| Professional | $194.98 | $316.23 | $501.19 |
Removal Of Impacted Tooth - Soft Tissue
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.65 | $128.82 | $204.17 | |
Anthem BCBS
| Professional | $162.18 | $177.83 | $234.42 | |
Harvard Pilgrim
| Professional | $194.98 | $316.23 | $501.19 |