| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $64.90 | $64.90 | $64.90 |
Alveoloplsty Conjnc Xtract 1-3 Teeth/Spaces Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $64.90 | $64.90 | $64.90 |