| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $152.94 | $152.94 | $152.94 | |
Providence
| Facility | $360.53 | $360.53 | $360.53 | |
Providence
| Professional | $156.57 | $234.89 | $338.80 |
Occlusal Adjustment - Complete
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $152.94 | $152.94 | $152.94 | |
Providence
| Facility | $360.53 | $360.53 | $360.53 | |
Providence
| Professional | $156.57 | $234.89 | $338.80 |