| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.81 | $23.81 | $24.39 | |
Cigna
| Professional | $11.50 | $24.39 | $24.39 | |
HMSA
| Professional | $21.29 | $24.47 | $28.14 | |
United
| Professional | $8.14 | $27.66 | $43.04 |
HYALOMATRIX, 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 | $23.81 | $23.81 | $24.39 | |
Cigna
| Professional | $11.50 | $24.39 | $24.39 | |
HMSA
| Professional | $21.29 | $24.47 | $28.14 | |
United
| Professional | $8.14 | $27.66 | $43.04 |