| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,137.96 | $1,137.96 | $1,137.96 | |
Aetna
| Professional | $306.20 | $509.69 | $1,137.96 | |
Anthem BCBS
| Professional | $522.98 | $725.05 | $1,457.69 |
Osseous Surg 4/> Contig/Tooth Bound Spaces-Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,137.96 | $1,137.96 | $1,137.96 | |
Aetna
| Professional | $306.20 | $509.69 | $1,137.96 | |
Anthem BCBS
| Professional | $522.98 | $725.05 | $1,457.69 |