| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.95 | $24.39 | $24.39 | |
BCBS
| Professional | $24.39 | $28.69 | $28.69 | |
Cigna
| Professional | $24.39 | $24.39 | $24.39 | |
United
| Professional | $28.69 | $28.69 | $28.69 |
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 | $22.95 | $24.39 | $24.39 | |
BCBS
| Professional | $24.39 | $28.69 | $28.69 | |
Cigna
| Professional | $24.39 | $24.39 | $24.39 | |
United
| Professional | $28.69 | $28.69 | $28.69 |