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Kansas 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
$165.96 / $3,162.28 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $134.90 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $57.54 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $4,265.80 / $4,466.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $158.49 / $263.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $208.93 / $3,162.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $204.17 / $3,630.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,445.44 / $3,311.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $158.49 / $234.42