| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $81.00 | $81.00 | $81.00 | |
Aetna
| Professional | $81.00 | $81.00 | $81.00 | |
Anthem BCBS
| Professional | $6.31 | $23.69 | $41.07 |
XCM biologic tissue 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
| Facility | $81.00 | $81.00 | $81.00 | |
Aetna
| Professional | $81.00 | $81.00 | $81.00 | |
Anthem BCBS
| Professional | $6.31 | $23.69 | $41.07 |