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 | $113.23 | $364.25 | $5,634.00 | |
Anthem BCBS
| Facility | $1,365.00 | $3,548.00 | $4,847.00 | |
CareSource
| Facility | $108.49 | $158.03 | $185.07 | |
United
| Facility | $933.00 | $2,252.00 | $4,426.00 |