| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.35 | $900.00 | $1,831.00 | |
United
| Facility | $225.00 | $513.00 | $1,581.00 |
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 | $109.35 | $900.00 | $1,831.00 | |
United
| Facility | $225.00 | $513.00 | $1,581.00 |