| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.91 | $70.91 | $70.91 | |
Aetna
| Professional | $70.91 | $73.12 | $185.25 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |
Plcmt Device Facilitate Eruption Impacted Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.91 | $70.91 | $70.91 | |
Aetna
| Professional | $70.91 | $73.12 | $185.25 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |