| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $258.36 | $258.36 | $8,500.00 | |
Aetna
| Professional | $250.69 | $258.36 | $293.23 | |
BCBS
| Professional | $537.34 | $573.51 | $674.72 | |
Medica
| Facility | $230.73 | $258.36 | $775.08 |
Remv Imp Tooth - Cmpl Bony W/Unusual Surg Comps
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $258.36 | $258.36 | $8,500.00 | |
Aetna
| Professional | $250.69 | $258.36 | $293.23 | |
BCBS
| Professional | $537.34 | $573.51 | $674.72 | |
Medica
| Facility | $230.73 | $258.36 | $775.08 |