| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $102.26 | $102.26 | $102.26 |
Alveoloplsty Not Cnjnc Xtrct 1-3 Teeth/Spce Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $102.26 | $102.26 | $102.26 |