| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,140.00 | $3,140.00 | $6,907.00 | |
Aetna
| Professional | $21.10 | $22.07 | $29.26 | |
Cigna
| Professional | $26.58 | $35.47 | $49.36 | |
United
| Professional | $28.68 | $42.33 | $96.94 |
Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, 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 | $3,140.00 | $3,140.00 | $6,907.00 | |
Aetna
| Professional | $21.10 | $22.07 | $29.26 | |
Cigna
| Professional | $26.58 | $35.47 | $49.36 | |
United
| Professional | $28.68 | $42.33 | $96.94 |