| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $138.94 | $138.94 | $138.94 | |
Providence
| Facility | $156.22 | $156.22 | $156.22 | |
Providence
| Professional | $139.11 | $208.68 | $301.00 |
Alveoloplasty In Conjunction With Extractions - One To Three Teeth Or Tooth Spaces, Per Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $138.94 | $138.94 | $138.94 | |
Providence
| Facility | $156.22 | $156.22 | $156.22 | |
Providence
| Professional | $139.11 | $208.68 | $301.00 |