| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $563.66 | $578.03 | $578.03 | |
Anthem BCBS
| Professional | $458.00 | $578.16 | $789.71 | |
Harvard Pilgrim
| Professional | $659.71 | $1,308.73 | $2,173.15 |
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 | $563.66 | $578.03 | $578.03 | |
Anthem BCBS
| Professional | $458.00 | $578.16 | $789.71 | |
Harvard Pilgrim
| Professional | $659.71 | $1,308.73 | $2,173.15 |