| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $1,691.00 | $3,382.00 | $4,707.00 | |
CDPHP
| Facility | $11.03 | $11.03 | $12,319.50 | |
CDPHP
| Professional | $11.03 | $11.03 | $11.03 |
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 |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $1,691.00 | $3,382.00 | $4,707.00 | |
CDPHP
| Facility | $11.03 | $11.03 | $12,319.50 | |
CDPHP
| Professional | $11.03 | $11.03 | $11.03 |