| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.25 | $123.25 | $1,399.70 | |
Aetna
| Professional | $116.00 | $123.25 | $123.25 |
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 | $123.25 | $123.25 | $1,399.70 | |
Aetna
| Professional | $116.00 | $123.25 | $123.25 |