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West Virginia 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
$17.35 / $23.97 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.20 / $22.50 / $30.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.82 / $19.86 / $21.63
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.22 / $19.22 / $19.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.59 / $28.59 / $28.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.02 / $24.71 / $69.56
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,305.67 / $1,690.45 / $4,978.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.59 / $33.46 / $52.32