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Rhode Island 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
$2,090.73 / $2,778.87 / $3,955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.59 / $224.56 / $291.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.80 / $273.35 / $448.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.74 / $336.26 / $641.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,838.00 / $5,111.00 / $9,622.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.82 / $413.60 / $687.14