| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $364.27 | $395.99 | $479.01 | |
Moda Health
| Facility | $357.83 | $466.27 | $613.13 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |
Autogenous Connective Tissue Graft Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $364.27 | $395.99 | $479.01 | |
Moda Health
| Facility | $357.83 | $466.27 | $613.13 | |
Molina
| Professional | $30.00 | $2,000.00 | $3,900.00 |