| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $165.96 | $173.78 | $177.83 | |
Cigna
| Professional | $177.83 | $177.83 | $177.83 | |
United
| Professional | $125.89 | $194.98 | $295.12 |
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 | $165.96 | $173.78 | $177.83 | |
Cigna
| Professional | $177.83 | $177.83 | $177.83 | |
United
| Professional | $125.89 | $194.98 | $295.12 |