go back

Nebraska 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
$1,506.15 / $4,241.22 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.26 / $22.38 / $90.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,335.87 / $4,387.57 / $8,486.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.12 / $29.60 / $45.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.99 / $53.12 / $76.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.09 / $41.09 / $1,242.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.64 / $54.65 / $3,779.26
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.38 / $52.16 / $76.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.97 / $51.11 / $67.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,775.00 / $4,406.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.64 / $53.99 / $59.07