| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $126.39 | $126.39 | $150.60 |
Bone Replacement Graft - Retained Natural Tooth - First Site In Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $126.39 | $126.39 | $150.60 |