| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,009.08 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $312.70 | $1,844.81 | $2,582.73 | |
Providence
| Facility | $312.70 | $1,844.81 | $2,582.73 |
Excision of mucosa of vestibule of mouth as donor graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,009.08 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $312.70 | $1,844.81 | $2,582.73 | |
Providence
| Facility | $312.70 | $1,844.81 | $2,582.73 |