| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.07 | $143.07 | $143.07 | |
Aetna
| Professional | $106.69 | $140.97 | $144.43 |
Bone Repl Gr - Ret Nat Tooth - Ea Add Site Quad
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.07 | $143.07 | $143.07 | |
Aetna
| Professional | $106.69 | $140.97 | $144.43 |