| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $98.35 | $98.35 | $171.72 | |
Aetna
| Professional | $98.35 | $152.94 | $191.77 | |
BCBS
| Professional | $74.00 | $74.00 | $74.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |
Bone Replacement Graft - Retained Natural Tooth - Each Additional Site In Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $98.35 | $98.35 | $171.72 | |
Aetna
| Professional | $98.35 | $152.94 | $191.77 | |
BCBS
| Professional | $74.00 | $74.00 | $74.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |