| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.65 | $72.65 | $72.65 | |
Aetna
| Professional | $72.65 | $148.69 | $163.22 | |
Horizon BCBS
| Professional | $140.28 | $165.04 | $169.96 |
Bone Replacement Graft - Retained Natural Tooth - Each Additional Site In Quadrant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.65 | $72.65 | $72.65 | |
Aetna
| Professional | $72.65 | $148.69 | $163.22 | |
Horizon BCBS
| Professional | $140.28 | $165.04 | $169.96 |