| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $135.66 | $135.66 | $135.66 | |
Aetna
| Professional | $123.62 | $135.66 | $204.27 |
Alveoloplsty Not Cnjnc Xtrct 1-3 Teeth/Spce Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $135.66 | $135.66 | $135.66 | |
Aetna
| Professional | $123.62 | $135.66 | $204.27 |