| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.49 | $2.49 | $2.49 | |
Cigna
| Facility | $2.49 | $2.49 | $2.49 | |
Cigna
| Professional | $2.49 | $2.49 | $2.49 | |
United
| Professional | $2.49 | $2.49 | $13.76 |
OASIS ultra tri-layer wound 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 | $2.49 | $2.49 | $2.49 | |
Cigna
| Facility | $2.49 | $2.49 | $2.49 | |
Cigna
| Professional | $2.49 | $2.49 | $2.49 | |
United
| Professional | $2.49 | $2.49 | $13.76 |