| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $367.93 | $367.93 | $367.93 | |
Providence
| Facility | $738.76 | $738.76 | $738.76 | |
Providence
| Professional | $368.47 | $552.76 | $797.30 |
Autogenous Connective Tissue Graft Procedure (Including Donor And Recipient Surgical Sites) First Tooth, Implant, Or Edentulous Tooth Position In Graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $367.93 | $367.93 | $367.93 | |
Providence
| Facility | $738.76 | $738.76 | $738.76 | |
Providence
| Professional | $368.47 | $552.76 | $797.30 |