| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $150.30 | $1,793.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $180.15 | $332.00 | $395.32 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |
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 | $150.30 | $1,793.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $180.15 | $332.00 | $395.32 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |