| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.66 | $3,838.05 | $4,242.51 | |
Aetna
| Facility | 50 | $487.52 | $487.52 | $4,323.91 |
Medica
| Facility | $213.66 | $277.76 | $612.50 |
Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.66 | $3,838.05 | $4,242.51 | |
Aetna
| Facility | 50 | $487.52 | $487.52 | $4,323.91 |
Medica
| Facility | $213.66 | $277.76 | $612.50 |