| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.90 | $44.90 | $44.90 | |
Aetna
| Professional | $43.11 | $44.90 | $44.90 | |
Medica
| Facility | $44.90 | $48.21 | $134.69 |
Occlusal Adjustment - Limited
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.90 | $44.90 | $44.90 | |
Aetna
| Professional | $43.11 | $44.90 | $44.90 | |
Medica
| Facility | $44.90 | $48.21 | $134.69 |