| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $113.22 | $165.42 | $172.10 |
Removal Of Impacted Tooth - Soft Tissue
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $113.22 | $165.42 | $172.10 |