go back

Mississippi 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
$65.23 / $784.00 / $1,831.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $68.98 / $153.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.00 / $146.00 / $146.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.93 / $71.63 / $130.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $529.00 / $1,739.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.89 / $79.28 / $164.40