| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $109.65 | $1,412.54 | |
CareSource
| Facility | $107.15 | $107.15 | $134.90 | |
Cigna
| Facility | $173.78 | $173.78 | $1,318.26 | |
United
| Facility | $457.09 | $457.09 | $457.09 |
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 | $100.00 | $109.65 | $1,412.54 | |
CareSource
| Facility | $107.15 | $107.15 | $134.90 | |
Cigna
| Facility | $173.78 | $173.78 | $1,318.26 | |
United
| Facility | $457.09 | $457.09 | $457.09 |