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 | $145.22 | $247.11 | $5,449.00 | |
Medcost
| Facility | $145.22 | $184.67 | $236.93 | |
United
| Facility | $361.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $655.93 | $655.93 | $12,000.00 |