| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,090.73 | $2,778.87 | $3,955.04 | |
BCBS
| Facility | $1,060.10 | $1,301.49 | $3,664.91 | |
United
| Facility | $540.00 | $1,401.00 | $4,915.00 |
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 | $2,090.73 | $2,778.87 | $3,955.04 | |
BCBS
| Facility | $1,060.10 | $1,301.49 | $3,664.91 | |
United
| Facility | $540.00 | $1,401.00 | $4,915.00 |