| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.04 | $3,575.00 | $4,601.00 | |
Kaiser Permanente
| Professional | $166.37 | $325.48 | $387.55 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |
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 | $147.04 | $3,575.00 | $4,601.00 | |
Kaiser Permanente
| Professional | $166.37 | $325.48 | $387.55 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |