| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $145.19 | $145.19 | $187.65 |
Alveoloplsty Not Cnjnc Xtrct 1-3 Teeth/Spce Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $145.19 | $145.19 | $187.65 |