| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.31 | $39.31 | $39.31 | |
Cigna
| Facility | $39.31 | $39.31 | $39.31 | |
Cigna
| Professional | $39.31 | $39.31 | $39.31 | |
United
| Professional | $39.31 | $39.31 | $654.30 |
Cygnus, 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 | $39.31 | $39.31 | $39.31 | |
Cigna
| Facility | $39.31 | $39.31 | $39.31 | |
Cigna
| Professional | $39.31 | $39.31 | $39.31 | |
United
| Professional | $39.31 | $39.31 | $654.30 |