| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.35 | $120.35 | $120.35 | |
Aetna
| Professional | $117.45 | $120.35 | $124.70 | |
Molina
| Professional | $45.00 | $61.68 | $67.42 |
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 | $120.35 | $120.35 | $120.35 | |
Aetna
| Professional | $117.45 | $120.35 | $124.70 | |
Molina
| Professional | $45.00 | $61.68 | $67.42 |