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 | $166.11 | $183.52 | $4,933.00 | |
BCBS
| Facility | $787.91 | $918.33 | $1,244.20 | |
Health Alliance Plan
| Facility | $176.96 | $2,056.00 | $4,933.00 | |
United
| Facility | $464.00 | $1,418.00 | $2,449.00 |