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Idaho rates for HCPCS 15272

Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,407.00 / $1,493.63 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.94 / $25.55 / $38.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.64 / $27.91 / $40.70
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.14 / $27.15 / $40.31
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.68 / $32.90 / $47.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $38.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.58 / $32.17 / $45.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.00 / $35.25 / $46.40