| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.82 | $794.33 | $2,041.74 | |
Cigna
| Facility | $446.68 | $446.68 | $446.68 | |
United
| Facility | $128.82 | $346.74 | $851.14 |
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 | $169.82 | $794.33 | $2,041.74 | |
Cigna
| Facility | $446.68 | $446.68 | $446.68 | |
United
| Facility | $128.82 | $346.74 | $851.14 |