| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Facility | $2,951.21 | $2,951.21 | $3,019.95 | |
United
| Professional | $5.37 | $7.41 | $8.32 |
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 |
|---|---|---|---|---|---|
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Facility | $2,951.21 | $2,951.21 | $3,019.95 | |
United
| Professional | $5.37 | $7.41 | $8.32 |