| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $295.12 | $1,288.25 | $3,890.45 | |
BCBS
| Facility | $0.02 | $2,041.74 | $5,248.07 | |
Christus
| Facility | $39.81 | $39.81 | $39.81 | |
United
| Facility | $208.93 | $512.86 | $1,258.93 |
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 | $295.12 | $1,288.25 | $3,890.45 | |
BCBS
| Facility | $0.02 | $2,041.74 | $5,248.07 | |
Christus
| Facility | $39.81 | $39.81 | $39.81 | |
United
| Facility | $208.93 | $512.86 | $1,258.93 |