| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $201.02 | $201.02 | $201.02 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 | |
Wellpoint
| Professional | $1.72 | $1.72 | $1.72 |
Suprathel, Per Sq Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $201.02 | $201.02 | $201.02 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 | |
Wellpoint
| Professional | $1.72 | $1.72 | $1.72 |