| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $265.19 | $5,491.19 | $9,637.10 | |
Anthem BCBS
| Facility | $3,315.00 | $3,788.00 | $4,735.00 | |
United
| Facility | $1,347.00 | $3,983.00 | $6,832.00 |
Split-thickness 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 | $265.19 | $5,491.19 | $9,637.10 | |
Anthem BCBS
| Facility | $3,315.00 | $3,788.00 | $4,735.00 | |
United
| Facility | $1,347.00 | $3,983.00 | $6,832.00 |