| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health Alliance Plan
| Facility | $469.90 | $469.90 | $469.90 | |
Health Alliance Plan
| Professional | $452.81 | $469.90 | $586.78 |
Ablative laser treatment, non-contact, full field and fractional ablation, open wound, per day, total treatment surface area; first 20 sq cm or less
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health Alliance Plan
| Facility | $469.90 | $469.90 | $469.90 | |
Health Alliance Plan
| Professional | $452.81 | $469.90 | $586.78 |