| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $486.60 | $1,146.18 | $1,985.78 | |
Hally Health
| Professional | $100.00 | $345.40 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |
Tissue Grafts, Other (Eg, Paratenon, Fat, Dermis)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $486.60 | $1,146.18 | $1,985.78 | |
Hally Health
| Professional | $100.00 | $345.40 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |