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Delaware 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
$101.20 / $191.59 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.38 / $39.38 / $74.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.49 / $63.75 / $99.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.25 / $82.85 / $182.27