| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,061.80 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $3,478.71 | $4,870.18 | $5,603.74 | |
Providence
| Facility | $3,478.71 | $4,870.18 | $5,603.74 |
Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,061.80 | $7,340.00 | $13,413.92 | |
Moda Health
| Facility | $3,478.71 | $4,870.18 | $5,603.74 | |
Providence
| Facility | $3,478.71 | $4,870.18 | $5,603.74 |