| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $191.93 | $191.93 | $1,400.00 | |
Aetna
| Professional | $191.93 | $273.32 | $286.44 |
Removal Of Impacted Tooth - Completely Bony, With Unusual Surgical Complications
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $191.93 | $191.93 | $1,400.00 | |
Aetna
| Professional | $191.93 | $273.32 | $286.44 |