| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $93.33 | $117.49 | $141.25 | |
United
| Professional | $104.71 | $125.89 | $125.89 |
SurGraft, per sq cm (add-on, list separately in addition to primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $93.33 | $117.49 | $141.25 | |
United
| Professional | $104.71 | $125.89 | $125.89 |