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
$69.18 / $954.99 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $64.57 / $114.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $41.69 / $41.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $70.79 / $131.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $588.84 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $72.44 / $114.82