| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $109.65 | |
Aetna
| Professional | $77.62 | $114.82 | $128.82 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
United
| Professional | $125.89 | $125.89 | $125.89 |
Amnion Bio or AxoBioMembrane, per sq cm (add-on, list separately in addition to primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $109.65 | |
Aetna
| Professional | $77.62 | $114.82 | $128.82 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
United
| Professional | $125.89 | $125.89 | $125.89 |