| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $140.56 | $146.19 | $163.22 | |
Medica
| Facility | $84.24 | $160.81 | $296.77 | |
Medica
| Professional | $1,053.42 | $1,053.42 | $1,053.42 |
Bone Replacement Graft - Retained Natural Tooth - Each Additional Site In Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $140.56 | $146.19 | $163.22 | |
Medica
| Facility | $84.24 | $160.81 | $296.77 | |
Medica
| Professional | $1,053.42 | $1,053.42 | $1,053.42 |