| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
AllWays Health Partners
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
Mass General Brigham
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
United
| Facility | $630.96 | $1,819.70 | $2,691.53 |
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 |
|---|---|---|---|---|---|
AllWays Health Partners
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
Mass General Brigham
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
United
| Facility | $630.96 | $1,819.70 | $2,691.53 |