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Oklahoma 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
$632.72 / $3,021.00 / $8,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.87 / $263.33 / $318.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,878.46 / $6,117.46 / $9,735.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.47 / $301.00 / $413.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.04 / $300.33 / $433.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.11 / $347.55 / $5,147.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.49 / $330.35 / $3,405.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,157.00 / $4,054.00 / $7,077.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.82 / $322.27 / $465.38