| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $391.00 | $1,230.00 | $3,500.00 | |
BCBS
| Facility | $364.96 | $607.99 | $1,069.35 | |
Christus
| Facility | $40.00 | $40.00 | $40.00 | |
United
| Facility | $194.00 | $513.00 | $1,226.00 |
Excision of mucosa of vestibule of mouth as donor graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $391.00 | $1,230.00 | $3,500.00 | |
BCBS
| Facility | $364.96 | $607.99 | $1,069.35 | |
Christus
| Facility | $40.00 | $40.00 | $40.00 | |
United
| Facility | $194.00 | $513.00 | $1,226.00 |