| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.11 | $39.11 | $39.11 | |
Aetna
| Professional | $39.11 | $39.11 | $54.53 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |
Occlusal Adjustment - Limited
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.11 | $39.11 | $39.11 | |
Aetna
| Professional | $39.11 | $39.11 | $54.53 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |