| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $164.49 | $164.49 | $164.49 | |
Aetna
| Professional | $164.49 | $164.49 | $225.93 | |
BCBS
| Professional | $193.48 | $194.93 | $229.33 | |
Medica
| Facility | $133.74 | $164.49 | $493.47 |
Alveoloplsty Not Cnjnc Xtrct 1-3 Teeth/Spce Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $164.49 | $164.49 | $164.49 | |
Aetna
| Professional | $164.49 | $164.49 | $225.93 | |
BCBS
| Professional | $193.48 | $194.93 | $229.33 | |
Medica
| Facility | $133.74 | $164.49 | $493.47 |