go back

North Carolina 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
$282.93 / $901.00 / $7,278.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.87 / $263.32 / $495.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.53 / $350.26 / $637.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.04 / $354.77 / $637.19
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.18 / $329.01 / $419.14
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.08 / $390.08 / $390.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,366.00 / $9,541.00 / $14,589.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.71 / $307.83 / $691.84
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $931.67 / $931.67
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,541.54 / $3,541.54 / $3,990.65