| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.92 | $37.78 | $54.53 | |
Medica
| Facility | $38.68 | $50.42 | $80.01 | |
Medica
| Professional | $283.32 | $283.32 | $283.32 |
Occlusal Adjustment - Limited
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.92 | $37.78 | $54.53 | |
Medica
| Facility | $38.68 | $50.42 | $80.01 | |
Medica
| Professional | $283.32 | $283.32 | $283.32 |