| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.00 | $81.00 | $81.00 | |
Medcost
| Facility | $105.30 | $105.30 | $105.30 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Xcm Biologic Tissue Matrix Per Square Centimeter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.00 | $81.00 | $81.00 | |
Medcost
| Facility | $105.30 | $105.30 | $105.30 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |