| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.26 | $583.63 | $2,331.21 | |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |
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 | $239.26 | $583.63 | $2,331.21 | |
United
| Facility | $7,448.00 | $7,448.00 | $7,448.00 |