| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $967.00 | $967.00 | $967.00 | |
Highmark BCBS
| Facility | $1,900.00 | $1,900.00 | $1,900.00 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $967.00 | $967.00 | $967.00 | |
Highmark BCBS
| Facility | $1,900.00 | $1,900.00 | $1,900.00 |