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New Jersey 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
$1,000.00 / $5,370.32 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $69.18 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $75.86 / $138.04
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $125.89 / $141.25
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $77.62 / $131.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $2,884.03 / $7,762.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $56.23 / $131.83