| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.59 | $3,038.00 | $4,387.00 | |
Aetna
| Professional | $177.59 | $177.59 | $219.34 | |
Molina
| Professional | $45.00 | $45.00 | $359.52 |
Removal Of Impacted Tooth - Completely Bony
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.59 | $3,038.00 | $4,387.00 | |
Aetna
| Professional | $177.59 | $177.59 | $219.34 | |
Molina
| Professional | $45.00 | $45.00 | $359.52 |