| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $56.04 | $73.12 | $87.54 |
Plcmt Device Facilitate Eruption Impacted Tooth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $56.04 | $73.12 | $87.54 |