| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.18 | $46.18 | $225.75 | |
Aetna
| Professional | $28.13 | $58.31 | $89.26 | |
United
| Professional | $45.00 | $87.00 | $131.00 |
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 | $46.18 | $46.18 | $225.75 | |
Aetna
| Professional | $28.13 | $58.31 | $89.26 | |
United
| Professional | $45.00 | $87.00 | $131.00 |