| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.88 | $22.91 | $24.55 | |
Cigna
| Facility | $45.71 | $45.71 | $45.71 | |
Cigna
| Professional | $24.55 | $24.55 | $24.55 | |
United
| Professional | $28.84 | $66.07 | $125.89 |
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 | $21.88 | $22.91 | $24.55 | |
Cigna
| Facility | $45.71 | $45.71 | $45.71 | |
Cigna
| Professional | $24.55 | $24.55 | $24.55 | |
United
| Professional | $28.84 | $66.07 | $125.89 |