| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.62 | $239.62 | $239.62 | |
Aetna
| Professional | $239.62 | $239.62 | $326.49 | |
Molina
| Professional | $45.00 | $45.00 | $458.76 |
Osseous Surg 1-3 Contig/Tooth Bound Spaces-Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.62 | $239.62 | $239.62 | |
Aetna
| Professional | $239.62 | $239.62 | $326.49 | |
Molina
| Professional | $45.00 | $45.00 | $458.76 |