| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $189.51 | $189.51 | $189.51 |
Osseous Surg 1-3 Contig/Tooth Bound Spaces-Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $189.51 | $189.51 | $189.51 |