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Maryland 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
Professional
Modifier
Low / Median / High Price
$16.20 / $24.03 / $43.52
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.07 / $18.07 / $22.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.57 / $23.41 / $44.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.08 / $31.06 / $57.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.00 / $150.00 / $150.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.77 / $30.26 / $58.20
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.80 / $23.24 / $28.90