| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $173.93 | $173.93 | $178.13 | |
Cigna
| Professional | $178.13 | $178.13 | $178.13 | |
United
| Professional | $189.91 | $202.90 | $304.35 |
Revitalon, 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 | $173.93 | $173.93 | $178.13 | |
Cigna
| Professional | $178.13 | $178.13 | $178.13 | |
United
| Professional | $189.91 | $202.90 | $304.35 |