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West Virginia 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
$210.90 / $2,066.76 / $6,513.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.87 / $263.32 / $321.24
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.30 / $231.29 / $251.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.99 / $223.99 / $223.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.19 / $329.19 / $329.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.66 / $306.41 / $766.29
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,826.60 / $2,826.60 / $2,826.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.50 / $377.34 / $553.16