| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $133.47 | $133.47 | $133.47 | |
Medica
| Professional | $202.51 | $202.51 | $202.51 | |
Midlands
| Facility | $15.04 | $15.04 | $16.60 | |
Midlands
| Professional | $12.62 | $15.04 | $20.74 |
Ablative laser treatment, non-contact, full field and fractional ablation, open wound, per day, total treatment surface area; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $133.47 | $133.47 | $133.47 | |
Medica
| Professional | $202.51 | $202.51 | $202.51 | |
Midlands
| Facility | $15.04 | $15.04 | $16.60 | |
Midlands
| Professional | $12.62 | $15.04 | $20.74 |