| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,137.96 | $2,570.40 | $2,951.21 | |
United
| Facility | $346.74 | $812.83 | $1,096.48 |
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 | $2,137.96 | $2,570.40 | $2,951.21 | |
United
| Facility | $346.74 | $812.83 | $1,096.48 |