| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.86 | $4,073.80 | $4,570.88 | |
Kaiser Permanente
| Professional | $158.49 | $204.17 | $389.05 | |
United
| Facility | $165.96 | $549.54 | $5,888.44 |
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 | $75.86 | $4,073.80 | $4,570.88 | |
Kaiser Permanente
| Professional | $158.49 | $204.17 | $389.05 | |
United
| Facility | $165.96 | $549.54 | $5,888.44 |