| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $175.90 | $3,701.00 | $10,439.00 | |
Cigna
| Facility | $442.00 | $442.00 | $442.00 | |
Medica
| Facility | $74.02 | $171.67 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |
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 | $175.90 | $3,701.00 | $10,439.00 | |
Cigna
| Facility | $442.00 | $442.00 | $442.00 | |
Medica
| Facility | $74.02 | $171.67 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |