| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.25 | $257.04 | $331.13 |
Removal Of Impacted Tooth - Completely Bony
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.25 | $257.04 | $331.13 |