| 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 |