| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $987.76 | $987.76 | $987.76 | |
Aetna
| Professional | $587.44 | $987.76 | $987.76 | |
Anthem BCBS
| Professional | $389.30 | $655.23 | $1,050.08 |
Autogenous Connective Tissue Graft Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $987.76 | $987.76 | $987.76 | |
Aetna
| Professional | $587.44 | $987.76 | $987.76 | |
Anthem BCBS
| Professional | $389.30 | $655.23 | $1,050.08 |