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Wyoming 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
$193.14 / $197.83 / $309.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.00 / $546.00 / $728.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.11 / $368.00 / $537.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,200.00 / $4,200.00 / $14,634.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.06 / $535.79 / $958.09