| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $4,466.84 | $4,466.84 | |
Kaiser Permanente
| Professional | $141.25 | $234.42 | $295.12 | |
United
| Facility | $1,071.52 | $1,071.52 | $1,071.52 |
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 | $1,778.28 | $4,466.84 | $4,466.84 | |
Kaiser Permanente
| Professional | $141.25 | $234.42 | $295.12 | |
United
| Facility | $1,071.52 | $1,071.52 | $1,071.52 |