| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,628.00 | $4,500.00 | $7,205.00 | |
Moda Health
| Facility | $85.72 | $128.94 | $243.40 | |
United
| Facility | $1,800.00 | $8,244.00 | $9,193.00 |
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 | $1,628.00 | $4,500.00 | $7,205.00 | |
Moda Health
| Facility | $85.72 | $128.94 | $243.40 | |
United
| Facility | $1,800.00 | $8,244.00 | $9,193.00 |