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Alabama rates for HCPCS 15274

Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,445.44 / $1,862.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $70.79 / $138.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $3,235.94 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $46.77 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $61.66 / $165.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $588.84 / $1,548.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $61.66 / $83.18