| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.28 | $217.57 | $7,278.00 | |
Medcost
| Facility | $74.28 | $137.55 | $220.08 | |
United
| Facility | $361.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $368.08 | $368.08 | $16,394.00 |
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 | $74.28 | $217.57 | $7,278.00 | |
Medcost
| Facility | $74.28 | $137.55 | $220.08 | |
United
| Facility | $361.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $368.08 | $368.08 | $16,394.00 |