| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $33.42 | $133.47 | $133.47 | |
Medica
| Professional | $8.57 | $202.51 | $202.51 |
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 | $33.42 | $133.47 | $133.47 | |
Medica
| Professional | $8.57 | $202.51 | $202.51 |