| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,715.00 | $5,122.00 | $10,692.00 | |
Aetna
| Professional | $36.00 | $36.00 | $36.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |
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 Additionto Code For Primary Procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,715.00 | $5,122.00 | $10,692.00 | |
Aetna
| Professional | $36.00 | $36.00 | $36.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |