| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.17 | $106.17 | $8,500.00 | |
Medica
| Facility | $106.17 | $165.28 | $202.25 |
Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.17 | $106.17 | $8,500.00 | |
Medica
| Facility | $106.17 | $165.28 | $202.25 |