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Massachusetts 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
$223.87 / $2,691.53 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $263.03 / $645.65
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $4,570.88 / $11,220.18
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $363.08 / $831.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $363.08 / $794.33
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $380.19 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $436.52 / $630.96
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,248.07 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $389.05 / $831.76
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $4,570.88 / $11,220.18
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $363.08 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $5,248.07 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $389.05 / $741.31