| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $194.35 | $247.86 | $266.69 | |
Cigna
| Professional | $216.38 | $216.38 | $261.97 | |
United
| Professional | $254.57 | $254.57 | $254.57 |
Microlyte Matrix, per sq cm (add-on, list separately in addition to primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $194.35 | $247.86 | $266.69 | |
Cigna
| Professional | $216.38 | $216.38 | $261.97 | |
United
| Professional | $254.57 | $254.57 | $254.57 |