| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $26,542.00 | $26,542.00 | $26,542.00 | |
Medica
| Professional | $2,625.27 | $2,625.27 | $2,625.27 |
Tissue Grafts, Other (Eg, Paratenon, Fat, Dermis)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $26,542.00 | $26,542.00 | $26,542.00 | |
Medica
| Professional | $2,625.27 | $2,625.27 | $2,625.27 |