| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $27.01 | $34.53 | $89.26 | |
BCBS
| Professional | $80.00 | $80.00 | $80.00 | |
Medica
| Facility | $34.13 | $36.43 | $113.41 | |
Medica
| Professional | $29.01 | $123.49 | $380.66 |
Consult Dx Serv Dent/Phy Not Requesting Dent/Phy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $27.01 | $34.53 | $89.26 | |
BCBS
| Professional | $80.00 | $80.00 | $80.00 | |
Medica
| Facility | $34.13 | $36.43 | $113.41 | |
Medica
| Professional | $29.01 | $123.49 | $380.66 |