| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.26 | $19.26 | $19.26 | |
Aetna
| Professional | $19.26 | $19.26 | $19.50 | |
Medica
| Facility | $19.26 | $20.21 | $80.00 | |
Medica
| Professional | $90.36 | $90.36 | $90.36 |
Dermal Substitute Native Non-Denatured Collagen Fetal Bovine Origin (Surgimend Collagen Matrix) Per 0.5 Square Centimeters)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.26 | $19.26 | $19.26 | |
Aetna
| Professional | $19.26 | $19.26 | $19.50 | |
Medica
| Facility | $19.26 | $20.21 | $80.00 | |
Medica
| Professional | $90.36 | $90.36 | $90.36 |