| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.97 | $5,000.27 | $7,838.38 | |
Providence
| Facility | $56.43 | $119.83 | $214.21 | |
United
| Facility | $230.00 | $1,158.00 | $1,401.00 |
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 | $137.97 | $5,000.27 | $7,838.38 | |
Providence
| Facility | $56.43 | $119.83 | $214.21 | |
United
| Facility | $230.00 | $1,158.00 | $1,401.00 |