| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $681.60 | $789.60 | $1,600.00 | |
CareSource
| Facility | $755.40 | $846.46 | $922.23 | |
Cigna
| Facility | $1,211.27 | $1,211.27 | $1,211.27 |
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 | $681.60 | $789.60 | $1,600.00 | |
CareSource
| Facility | $755.40 | $846.46 | $922.23 | |
Cigna
| Facility | $1,211.27 | $1,211.27 | $1,211.27 |