| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $933.25 | $4,897.79 | |
Aetna
| Professional | $114.82 | $120.23 | $123.03 | |
Cigna
| Facility | $123.03 | $123.03 | $123.03 | |
Wellpoint
| Professional | $44.67 | $44.67 | $44.67 |
Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Putty, Integra OS Osteoconductive Scaffold Putty), per 0.5 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $933.25 | $4,897.79 | |
Aetna
| Professional | $114.82 | $120.23 | $123.03 | |
Cigna
| Facility | $123.03 | $123.03 | $123.03 | |
Wellpoint
| Professional | $44.67 | $44.67 | $44.67 |