| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $288.02 | $352.85 | $352.85 |
Osseous Surg 4/> Contig/Tooth Bound Spaces-Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $288.02 | $352.85 | $352.85 |