| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.65 | $3,158.00 | $10,439.00 | |
Cigna
| Facility | $624.00 | $624.00 | $624.00 | |
Medica
| Facility | $45.26 | $84.80 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |
Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.65 | $3,158.00 | $10,439.00 | |
Cigna
| Facility | $624.00 | $624.00 | $624.00 | |
Medica
| Facility | $45.26 | $84.80 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |