| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Wellpoint
| Professional | $34.50 | $34.50 | $34.50 |
Human Health Factor 10 Amniotic Patch (HHF10-P), per sq cm (add-on, list separately in addition to primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Wellpoint
| Professional | $34.50 | $34.50 | $34.50 |