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Vermont 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
Professional
Modifier
Low / Median / High Price
$200.96 / $289.66 / $533.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.23 / $324.38 / $891.53
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.62 / $445.17 / $891.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.86 / $439.82 / $1,278.59