| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,090.73 | $2,778.87 | $3,955.04 | |
United
| Facility | $540.00 | $1,401.00 | $4,915.00 |
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 | $2,090.73 | $2,778.87 | $3,955.04 | |
United
| Facility | $540.00 | $1,401.00 | $4,915.00 |