| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.96 | $10.96 | $10.96 | |
Aetna
| Professional | $5.01 | $5.01 | $25.12 | |
United
| Professional | $109.65 | $125.89 | $125.89 |
Strattice, per sq cm (add-on, list separately in addition to primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.96 | $10.96 | $10.96 | |
Aetna
| Professional | $5.01 | $5.01 | $25.12 | |
United
| Professional | $109.65 | $125.89 | $125.89 |