| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $911.00 | $1,713.00 | $4,473.00 | |
Hometown Health
| Professional | $3.60 | $189.61 | $276.52 | |
United
| Facility | $1,642.00 | $3,060.00 | $9,042.00 |
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 | $911.00 | $1,713.00 | $4,473.00 | |
Hometown Health
| Professional | $3.60 | $189.61 | $276.52 | |
United
| Facility | $1,642.00 | $3,060.00 | $9,042.00 |