| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.88 | $78.88 | $78.88 | |
Aetna
| Professional | $34.13 | $78.88 | $89.26 | |
Cigna
| Professional | $88.31 | $88.31 | $88.31 |
Consultation - Diagnostic Service Provided By Dentist Or Physician Other Than Requesting Dentist Or Physician
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.88 | $78.88 | $78.88 | |
Aetna
| Professional | $34.13 | $78.88 | $89.26 | |
Cigna
| Professional | $88.31 | $88.31 | $88.31 |