| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $188.17 | $5,975.00 | $10,871.00 | |
Aetna
| Professional | $183.25 | $193.53 | $212.80 |
Removal Of Impacted Tooth - Completely Bony
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $188.17 | $5,975.00 | $10,871.00 | |
Aetna
| Professional | $183.25 | $193.53 | $212.80 |