| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13,500.00 | $13,500.00 | $13,500.00 | |
Christus
| Facility | $121.37 | $121.37 | $121.37 |
NovoSorb SynPath dermal 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
| Facility | $13,500.00 | $13,500.00 | $13,500.00 | |
Christus
| Facility | $121.37 | $121.37 | $121.37 |