| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.00 | $787.00 | $8,229.00 | |
Aetna
| Professional | $36.00 | $36.00 | $36.00 | |
Anthem BCBS
| Professional | $8.01 | $8.01 | $8.01 | |
United
| Facility | $50.00 | $597.00 | $1,895.00 |
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.00 | $787.00 | $8,229.00 | |
Aetna
| Professional | $36.00 | $36.00 | $36.00 | |
Anthem BCBS
| Professional | $8.01 | $8.01 | $8.01 | |
United
| Facility | $50.00 | $597.00 | $1,895.00 |