| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,139.73 | $8,138.20 | $26,542.00 | |
Medica
| Professional | $2,625.27 | $2,625.27 | $2,625.27 |
Tissue Grafts Other
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,139.73 | $8,138.20 | $26,542.00 | |
Medica
| Professional | $2,625.27 | $2,625.27 | $2,625.27 |