| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $107.15 | $147.91 | $204.17 | |
Anthem BCBS
| Professional | $117.49 | $194.98 | $281.84 | |
Harvard Pilgrim
| Professional | $234.42 | $354.81 | $512.86 |
Bone Replacement Graft - Retained Natural Tooth - Each Additional Site In Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $107.15 | $147.91 | $204.17 | |
Anthem BCBS
| Professional | $117.49 | $194.98 | $281.84 | |
Harvard Pilgrim
| Professional | $234.42 | $354.81 | $512.86 |