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New York 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
$257.63 / $2,920.00 / $8,442.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.64 / $261.95 / $513.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,263.00 / $5,196.00 / $11,909.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.98 / $277.30 / $611.41
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.77 / $1,716.00 / $6,213.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.77 / $278.77 / $448.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.19 / $329.19 / $329.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.37 / $338.91 / $727.44
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $232.82 / $503.89
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.08 / $411.57 / $872.43
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.22 / $291.88 / $567.11
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.19 / $555.00 / $74,999.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.32 / $375.29 / $785.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,160.00 / $5,248.00 / $11,200.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.93 / $337.18 / $760.92
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.93 / $206.93 / $423.40
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.22 / $329.49 / $647.92