| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.04 | $3,630.78 | $8,317.64 | |
Cigna
| Facility | $446.68 | $446.68 | $446.68 | |
Medica
| Facility | $79.43 | $177.83 | $2,818.38 | |
United
| Facility | $190.55 | $537.03 | $1,905.46 |
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 | $138.04 | $3,630.78 | $8,317.64 | |
Cigna
| Facility | $446.68 | $446.68 | $446.68 | |
Medica
| Facility | $79.43 | $177.83 | $2,818.38 | |
United
| Facility | $190.55 | $537.03 | $1,905.46 |