| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,513.56 | $3,981.07 | $7,413.10 | |
United
| Facility | $436.52 | $1,412.54 | $6,456.54 |
Excision of mucosa of vestibule of mouth as donor graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,513.56 | $3,981.07 | $7,413.10 | |
United
| Facility | $436.52 | $1,412.54 | $6,456.54 |