| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $46.77 | $63.10 | $91.20 | |
Cigna
| Professional | $93.33 | $93.33 | $93.33 | |
United
| Professional | $91.20 | $125.89 | $199.53 |
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 | $46.77 | $63.10 | $91.20 | |
Cigna
| Professional | $93.33 | $93.33 | $93.33 | |
United
| Professional | $91.20 | $125.89 | $199.53 |