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Maine 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
$13.97 / $35.40 / $241.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.97 / $20.82 / $38.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.59 / $27.44 / $39.24
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$27.88 / $41.16 / $58.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.27 / $31.14 / $51.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.61 / $30.39 / $50.66
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.40 / $35.40 / $241.02
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.97 / $20.82 / $45.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.16 / $37.38 / $49.37