| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.00 | $26.00 | $26.00 | |
Aetna
| Professional | $26.00 | $26.00 | $26.00 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |
Mediskin, 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 | $26.00 | $26.00 | $26.00 | |
Aetna
| Professional | $26.00 | $26.00 | $26.00 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |