| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $683.74 | $798.51 | $8,500.00 | |
Medica
| Facility | $683.74 | $997.14 | $2,051.21 |
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 | $683.74 | $798.51 | $8,500.00 | |
Medica
| Facility | $683.74 | $997.14 | $2,051.21 |