| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $1,251.00 | $2,250.00 | |
BCBS
| Facility | $2,607.25 | $3,164.02 | $4,256.62 | |
United
| Facility | $625.00 | $1,738.00 | $3,362.00 |
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $1,251.00 | $2,250.00 | |
BCBS
| Facility | $2,607.25 | $3,164.02 | $4,256.62 | |
United
| Facility | $625.00 | $1,738.00 | $3,362.00 |