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South Carolina 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
$48.44 / $3,776.00 / $9,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.27 / $62.72 / $128.06
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.47 / $43.47 / $43.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.06 / $780.00 / $1,357.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.44 / $53.55 / $90.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.04 / $71.61 / $108.56
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.26 / $79.03 / $106.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.95 / $65.88 / $90.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $1,221.00 / $3,585.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.36 / $75.03 / $125.94