| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,862.09 | $3,388.44 | $6,025.60 | |
U of Utah Health Plan
| Professional | $1,862.09 | $2,290.87 | $3,162.28 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |
Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,862.09 | $3,388.44 | $6,025.60 | |
U of Utah Health Plan
| Professional | $1,862.09 | $2,290.87 | $3,162.28 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |