| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.57 | $113.57 | $113.57 | |
Aetna
| Professional | $113.57 | $113.57 | $259.00 | |
Molina
| Professional | $45.00 | $45.00 | $214.71 |
Removal Of Impacted Tooth - Soft Tissue
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.57 | $113.57 | $113.57 | |
Aetna
| Professional | $113.57 | $113.57 | $259.00 | |
Molina
| Professional | $45.00 | $45.00 | $214.71 |