| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.72 | $3,038.00 | $4,626.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |
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 | $85.72 | $3,038.00 | $4,626.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |