| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.21 | $28.21 | $753.00 | |
Aetna
| Professional | $28.21 | $39.29 | $47.20 |
Occlusal Adjustment - Limited
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.21 | $28.21 | $753.00 | |
Aetna
| Professional | $28.21 | $39.29 | $47.20 |