go back

Colorado 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
$81.09 / $3,000.00 / $8,652.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.27 / $62.71 / $110.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.83 / $88.79 / $152.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.69 / $79.54 / $121.02
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.55 / $73.16 / $110.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $82.67 / $155.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.00 / $1,464.00 / $3,011.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.84 / $104.55 / $164.30