| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.23 | $4,570.88 | $8,511.38 | |
Anthem BCBS
| Facility | $3,311.31 | $3,801.89 | $4,786.30 | |
United
| Facility | $1,288.25 | $3,890.45 | $6,760.83 |
Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; 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 | $316.23 | $4,570.88 | $8,511.38 | |
Anthem BCBS
| Facility | $3,311.31 | $3,801.89 | $4,786.30 | |
United
| Facility | $1,288.25 | $3,890.45 | $6,760.83 |