| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $568.60 | $7,629.00 | $10,492.00 | |
Aetna
| Professional | $250.69 | $568.60 | $568.60 | |
Anthem BCBS
| Professional | $278.80 | $376.88 | $621.76 |
Remv Imp Tooth - Cmpl Bony W/Unusual Surg Comps
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $568.60 | $7,629.00 | $10,492.00 | |
Aetna
| Professional | $250.69 | $568.60 | $568.60 | |
Anthem BCBS
| Professional | $278.80 | $376.88 | $621.76 |