| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $64.57 | $64.57 | $91.20 | |
Cigna
| Facility | $66.07 | $66.07 | $66.07 | |
Cigna
| Professional | $66.07 | $66.07 | $66.07 | |
United
| Professional | $125.89 | $151.36 | $177.83 |
Neox 100 or Clarix 100, 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 | $64.57 | $64.57 | $91.20 | |
Cigna
| Facility | $66.07 | $66.07 | $66.07 | |
Cigna
| Professional | $66.07 | $66.07 | $66.07 | |
United
| Professional | $125.89 | $151.36 | $177.83 |