| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $347.62 | $347.62 | $347.62 | |
Aetna
| Professional | $106.69 | $141.69 | $347.62 | |
Anthem BCBS
| Professional | $100.30 | $159.50 | $320.17 |
Bone Replacement Graft - Retained Natural Tooth - Each Additional Site In Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $347.62 | $347.62 | $347.62 | |
Aetna
| Professional | $106.69 | $141.69 | $347.62 | |
Anthem BCBS
| Professional | $100.30 | $159.50 | $320.17 |