| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $176.54 | $429.07 | $2,331.21 | |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |
Epidermal 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 | $176.54 | $429.07 | $2,331.21 | |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |