| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $708.55 | $708.55 | $8,500.00 | |
Medica
| Facility | $708.55 | $845.46 | $2,125.65 | |
United
| Facility | $2,545.00 | $2,545.00 | $2,545.00 |
Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $708.55 | $708.55 | $8,500.00 | |
Medica
| Facility | $708.55 | $845.46 | $2,125.65 | |
United
| Facility | $2,545.00 | $2,545.00 | $2,545.00 |