| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $36.00 | $36.00 | $43.20 | |
Cigna
| Professional | $84.00 | $84.00 | $84.00 | |
MVP Health Care
| Professional | $84.00 | $84.00 | $84.00 |
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
| Professional | $36.00 | $36.00 | $43.20 | |
Cigna
| Professional | $84.00 | $84.00 | $84.00 | |
MVP Health Care
| Professional | $84.00 | $84.00 | $84.00 |