| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,090.73 | $2,778.87 | $3,955.04 | |
BCBS
| Facility | $3,401.14 | $3,734.41 | $5,551.06 | |
United
| Facility | $1,812.00 | $4,049.00 | $5,510.00 |
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 | $2,090.73 | $2,778.87 | $3,955.04 | |
BCBS
| Facility | $3,401.14 | $3,734.41 | $5,551.06 | |
United
| Facility | $1,812.00 | $4,049.00 | $5,510.00 |