| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $430.12 | $430.12 | $7,045.00 | |
Moda Health
| Facility | $172.30 | $348.60 | $437.35 | |
United
| Facility | $1,500.00 | $9,360.00 | $17,870.00 |
Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $430.12 | $430.12 | $7,045.00 | |
Moda Health
| Facility | $172.30 | $348.60 | $437.35 | |
United
| Facility | $1,500.00 | $9,360.00 | $17,870.00 |