| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $651.57 | $5,109.00 | $9,860.00 | |
Horizon BCBS
| Facility | $3,707.40 | $4,447.22 | $8,481.31 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |
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 | $651.57 | $5,109.00 | $9,860.00 | |
Horizon BCBS
| Facility | $3,707.40 | $4,447.22 | $8,481.31 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |