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Delaware 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
$94.22 / $363.19 / $18,561.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.90 / $134.77 / $141.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.79 / $146.87 / $220.10
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,838.98 / $2,838.98 / $8,385.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.34 / $186.99 / $361.02