| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,599.00 | $7,833.00 | $12,916.00 |
Tissue Grafts, Other (Eg, Paratenon, Fat, Dermis)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,599.00 | $7,833.00 | $12,916.00 |