| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $179.51 | $179.51 | $179.51 | |
Aetna
| Professional | $73.12 | $107.45 | $179.51 | |
Anthem BCBS
| Professional | $94.57 | $128.75 | $644.12 |
Plcmt Device Facilitate Eruption Impacted Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $179.51 | $179.51 | $179.51 | |
Aetna
| Professional | $73.12 | $107.45 | $179.51 | |
Anthem BCBS
| Professional | $94.57 | $128.75 | $644.12 |