go back

Tennessee 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
$44.91 / $1,821.00 / $6,681.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.85 / $20.28 / $28.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.00 / $148.00 / $1,676.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.95 / $24.59 / $40.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.29 / $25.29 / $50.61
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $80.94 / $80.94
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,376.87 / $3,779.26 / $3,930.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $794.00 / $2,577.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.55 / $30.99 / $58.05