| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,818.38 | $4,466.84 | $8,709.64 | |
United
| Facility | $512.86 | $512.86 | $7,413.10 |
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 | $2,818.38 | $4,466.84 | $8,709.64 | |
United
| Facility | $512.86 | $512.86 | $7,413.10 |