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Missouri 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
$20.66 / $2,507.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.21 / $20.66 / $63.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,958.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.35 / $24.51 / $38.97
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$23.02 / $36.72 / $58.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.89 / $27.93 / $46.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.26 / $33.15 / $875.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.01 / $33.21 / $3,779.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $875.00 / $1,351.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.17 / $29.31 / $48.91