| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $224.63 | $4,376.00 | $12,154.00 | |
Cigna
| Facility | $505.00 | $505.00 | $505.00 | |
Medica
| Facility | $110.75 | $220.08 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |
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 | $224.63 | $4,376.00 | $12,154.00 | |
Cigna
| Facility | $505.00 | $505.00 | $505.00 | |
Medica
| Facility | $110.75 | $220.08 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |