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Georgia 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
$489.78 / $3,548.13 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $70.79 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $60.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $7,943.28 / $7,943.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $74.13 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $72.44 / $154.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $97.72 / $147.91
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $100.00 / $117.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $1,513.56 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $81.28 / $158.49