| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $187.65 | $192.79 | $192.79 | |
Anthem BCBS
| Professional | $175.00 | $192.40 | $263.24 | |
Harvard Pilgrim
| Professional | $219.90 | $436.24 | $724.37 |
Alveoloplsty Not Cnjnc Xtrct 1-3 Teeth/Spce Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $187.65 | $192.79 | $192.79 | |
Anthem BCBS
| Professional | $175.00 | $192.40 | $263.24 | |
Harvard Pilgrim
| Professional | $219.90 | $436.24 | $724.37 |