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Nevada 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
$82.05 / $1,639.00 / $4,473.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.27 / $62.71 / $126.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.00 / $333.00 / $333.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.10 / $60.68 / $113.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.65 / $63.03 / $111.48
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.02 / $59.72 / $131.50
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $37.79 / $128.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $1,427.00 / $1,998.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.31 / $81.56 / $142.38