| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,324.03 | $2,747.00 | $4,456.00 | |
Kaiser Permanente
| Professional | $126.63 | $200.00 | $236.81 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 |
Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,324.03 | $2,747.00 | $4,456.00 | |
Kaiser Permanente
| Professional | $126.63 | $200.00 | $236.81 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 |