| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $252.98 | $252.98 | $252.98 | |
Aetna
| Professional | $252.98 | $332.41 | $475.16 |
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
| Facility | $252.98 | $252.98 | $252.98 | |
Aetna
| Professional | $252.98 | $332.41 | $475.16 |