| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.56 | $76.56 | $753.00 | |
Aetna
| Professional | $76.56 | $140.37 | $204.50 |
Alveoloplsty Not Cnjnc Xtrct 1-3 Teeth/Spce Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.56 | $76.56 | $753.00 | |
Aetna
| Professional | $76.56 | $140.37 | $204.50 |