| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $73.12 | $167.39 | $208.37 | |
CareFirst
| Professional | $90.00 | $90.00 | $170.00 | |
Kaiser Permanente
| Professional | $242.25 | $313.42 | $364.45 |
Plcmt Device Facilitate Eruption Impacted Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $73.12 | $167.39 | $208.37 | |
CareFirst
| Professional | $90.00 | $90.00 | $170.00 | |
Kaiser Permanente
| Professional | $242.25 | $313.42 | $364.45 |