| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $960.00 | $2,400.00 | $2,400.00 | |
Medica
| Professional | $3,160.00 | $3,160.00 | $3,160.00 |
Axolotl Graft or Axolotl DualGraft, per sq cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $960.00 | $2,400.00 | $2,400.00 | |
Medica
| Professional | $3,160.00 | $3,160.00 | $3,160.00 |