| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $320.45 | $4,294.00 | $9,860.00 | |
Horizon BCBS
| Facility | $999.13 | $1,032.11 | $2,684.77 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |
Excision of mucosa of vestibule of mouth as donor graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $320.45 | $4,294.00 | $9,860.00 | |
Horizon BCBS
| Facility | $999.13 | $1,032.11 | $2,684.77 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |