| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
MountainHealth Co-op
| Facility | $1,230.27 | $1,737.80 | $1,778.28 | |
MountainHealth Co-op
| Professional | $1,230.27 | $1,737.80 | $1,778.28 |
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 |
|---|---|---|---|---|---|
MountainHealth Co-op
| Facility | $1,230.27 | $1,737.80 | $1,778.28 | |
MountainHealth Co-op
| Professional | $1,230.27 | $1,737.80 | $1,778.28 |