| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,424.33 | $1,424.33 | $2,897.49 | |
Kaiser Permanente
| Professional | $130.94 | $176.63 | $342.10 | |
United
| Facility | $150.00 | $150.00 | $150.00 |
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 | $1,424.33 | $1,424.33 | $2,897.49 | |
Kaiser Permanente
| Professional | $130.94 | $176.63 | $342.10 | |
United
| Facility | $150.00 | $150.00 | $150.00 |