| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $136.22 | $160.51 | $195.90 | |
Moda Health
| Facility | $66.98 | $160.51 | $227.97 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |
Bone Replacement Graft - Retained Natural Tooth - Each Additional Site In Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $136.22 | $160.51 | $195.90 | |
Moda Health
| Facility | $66.98 | $160.51 | $227.97 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |