| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $254.04 | $347.01 | $1,400.00 | |
CareSource
| Facility | $248.72 | $273.79 | $325.17 | |
Cigna
| Facility | $439.02 | $439.02 | $439.02 |
Excision of mucosa of vestibule of mouth as donor graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $254.04 | $347.01 | $1,400.00 | |
CareSource
| Facility | $248.72 | $273.79 | $325.17 | |
Cigna
| Facility | $439.02 | $439.02 | $439.02 |