Dermal 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
| Professional | $91.17 | $98.07 | $240.44 | |
Cigna
| Professional | $91.73 | $122.08 | $219.26 | |
MVP Health Care
| Professional | $94.15 | $129.38 | $219.26 | |
United
| Professional | $103.29 | $137.11 | $400.36 |