| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
United
| Facility | $489.78 | $1,071.52 | $1,905.46 |
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 |
|---|---|---|---|---|---|
Lucent Health
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
United
| Facility | $489.78 | $1,071.52 | $1,905.46 |