| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $758.58 | $1,445.44 | $2,238.72 | |
BCBS
| Facility | $2,691.53 | $3,235.94 | $4,365.16 | |
United
| Facility | $251.19 | $549.54 | $1,348.96 |
Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, 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 | $758.58 | $1,445.44 | $2,238.72 | |
BCBS
| Facility | $2,691.53 | $3,235.94 | $4,365.16 | |
United
| Facility | $251.19 | $549.54 | $1,348.96 |