| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $831.76 | $10,000.00 | $16,982.44 | |
Moda Health
| Facility | $257.04 | $794.33 | $1,905.46 | |
Providence
| Facility | $275.42 | $794.33 | $1,513.56 |
Bone graft, any donor area; major or large
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $831.76 | $10,000.00 | $16,982.44 | |
Moda Health
| Facility | $257.04 | $794.33 | $1,905.46 | |
Providence
| Facility | $275.42 | $794.33 | $1,513.56 |