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 | $181.97 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $40.74 | $128.82 | $128.82 | |
Health Alliance Plan
| Facility | $181.97 | $2,041.74 | $4,897.79 | |
United
| Facility | $467.74 | $1,258.93 | $2,041.74 |