| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $794.33 | $2,344.23 | $4,168.69 | |
United
| Facility | $478.63 | $1,258.93 | $1,819.70 |
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $794.33 | $2,344.23 | $4,168.69 | |
United
| Facility | $478.63 | $1,258.93 | $1,819.70 |