| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $202.51 | $202.51 | $202.51 | |
Midlands
| Professional | $16.60 | $16.60 | $16.60 |
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
| Professional | $202.51 | $202.51 | $202.51 | |
Midlands
| Professional | $16.60 | $16.60 | $16.60 |