| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.79 | $62.89 | $102.00 | |
Cigna
| Facility | $93.13 | $93.13 | $93.13 | |
Cigna
| Professional | $93.13 | $93.13 | $93.13 | |
United
| Professional | $91.30 | $100.14 | $136.94 |
Symphony, 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 | $49.79 | $62.89 | $102.00 | |
Cigna
| Facility | $93.13 | $93.13 | $93.13 | |
Cigna
| Professional | $93.13 | $93.13 | $93.13 | |
United
| Professional | $91.30 | $100.14 | $136.94 |