| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.49 | $12.49 | $12.49 | |
Cigna
| Facility | $12.49 | $12.49 | $12.49 | |
Cigna
| Professional | $12.49 | $12.49 | $12.49 | |
United
| Professional | $12.49 | $12.49 | $20.23 |
Oasis burn matrix, 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 | $12.49 | $12.49 | $12.49 | |
Cigna
| Facility | $12.49 | $12.49 | $12.49 | |
Cigna
| Professional | $12.49 | $12.49 | $12.49 | |
United
| Professional | $12.49 | $12.49 | $20.23 |