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Florida 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
$134.37 / $3,000.00 / $9,095.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $126.27 / $197.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.68 / $75.68 / $117.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.43 / $88.84 / $323.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.42 / $140.69 / $225.75
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,144.00 / $5,731.00 / $11,037.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.25 / $121.08 / $182.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.51 / $163.62 / $223.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,014.00 / $3,611.00 / $8,105.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.44 / $148.43 / $264.32
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.48 / $121.53 / $121.53