| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.39 | $34.39 | $34.39 | |
Aetna
| Professional | $34.39 | $34.39 | $34.79 | |
Medica
| Facility | $34.39 | $36.54 | $65.02 | |
Medica
| Professional | $41.56 | $69.93 | $283.32 |
Occlusal Adjustment - Limited
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.39 | $34.39 | $34.39 | |
Aetna
| Professional | $34.39 | $34.39 | $34.79 | |
Medica
| Facility | $34.39 | $36.54 | $65.02 | |
Medica
| Professional | $41.56 | $69.93 | $283.32 |