| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $920.00 | $1,688.00 | $3,804.00 | |
Aetna
| Professional | $1,305.00 | $1,305.00 | $1,846.00 | |
United
| Facility | $130.00 | $328.00 | $858.00 |
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, 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 | $920.00 | $1,688.00 | $3,804.00 | |
Aetna
| Professional | $1,305.00 | $1,305.00 | $1,846.00 | |
United
| Facility | $130.00 | $328.00 | $858.00 |