| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.64 | $20.64 | $20.64 | |
Aetna
| Professional | $20.64 | $20.64 | $20.89 | |
Medica
| Facility | $20.64 | $21.66 | $80.00 | |
Medica
| Professional | $96.82 | $96.82 | $96.82 |
Dermal substitute, native, nondenatured collagen, neonatal bovine origin (SurgiMend Collagen Matrix), per 0.5 sq cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.64 | $20.64 | $20.64 | |
Aetna
| Professional | $20.64 | $20.64 | $20.89 | |
Medica
| Facility | $20.64 | $21.66 | $80.00 | |
Medica
| Professional | $96.82 | $96.82 | $96.82 |