| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,003.74 | $1,003.74 | $8,500.00 | |
Medica
| Facility | $1,003.74 | $1,228.76 | $1,768.18 |
Graft Facial Nerve Paralysis Free Fascial Graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,003.74 | $1,003.74 | $8,500.00 | |
Medica
| Facility | $1,003.74 | $1,228.76 | $1,768.18 |