| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.44 | $1,445.44 | $1,862.09 | |
BCBS
| Facility | $2,691.53 | $3,235.94 | $4,365.16 | |
United
| Facility | $251.19 | $549.54 | $1,348.96 |
Tissue cultured skin autograft, trunk, arms, legs; 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 | $575.44 | $1,445.44 | $1,862.09 | |
BCBS
| Facility | $2,691.53 | $3,235.94 | $4,365.16 | |
United
| Facility | $251.19 | $549.54 | $1,348.96 |