| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $128.82 | $128.82 | |
Aetna
| Professional | $58.88 | $85.11 | $102.33 | |
Cigna
| Professional | $93.33 | $93.33 | $93.33 | |
United
| Professional | $91.20 | $91.20 | $125.89 |
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
| Facility | $128.82 | $128.82 | $128.82 | |
Aetna
| Professional | $58.88 | $85.11 | $102.33 | |
Cigna
| Professional | $93.33 | $93.33 | $93.33 | |
United
| Professional | $91.20 | $91.20 | $125.89 |