| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.59 | $185.25 | $188.98 | |
Moda Health
| Facility | $45.63 | $188.98 | $241.89 | |
Molina
| Professional | $30.00 | $3,500.00 | $3,900.00 |
Plcmt Device Facilitate Eruption Impacted Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.59 | $185.25 | $188.98 | |
Moda Health
| Facility | $45.63 | $188.98 | $241.89 | |
Molina
| Professional | $30.00 | $3,500.00 | $3,900.00 |