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Washington, DC rates for HCPCS 15273

Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $4,073.80 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $263.03 / $380.19
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $1,659.59 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $295.12 / $524.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $512.86 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $10,000.00 / $26,915.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $295.12 / $616.60