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Connecticut rates for HCPCS 15275

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.00 / $4,664.00 / $9,505.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.20 / $138.60 / $391.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,931.00 / $13,478.00 / $17,938.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.54 / $147.69 / $220.09
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$143.31 / $221.54 / $330.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.85 / $185.85 / $303.04
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.12 / $191.91 / $200.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,414.00 / $5,950.00 / $9,338.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.24 / $196.41 / $310.20