| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $287.92 | $287.92 | $287.92 | |
Kaiser Permanente
| Professional | $365.39 | $484.03 | $855.95 |
Excision of mucosa of vestibule of mouth as donor graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $287.92 | $287.92 | $287.92 | |
Kaiser Permanente
| Professional | $365.39 | $484.03 | $855.95 |