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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
$78.83 / $927.00 / $2,250.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $59.93 / $82.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,607.25 / $3,164.02 / $4,256.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.25 / $47.28 / $73.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.74 / $58.62 / $136.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.00 / $858.00 / $1,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.54 / $72.20 / $96.35