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Mississippi 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
$80.68 / $936.00 / $2,356.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.98 / $134.77 / $226.73
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.83 / $134.83 / $134.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,065.94 / $1,065.94 / $1,065.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.00 / $389.00 / $389.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.02 / $92.02 / $2,447.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.15 / $157.16 / $289.37
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$610.00 / $1,354.00 / $4,939.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.43 / $166.80 / $361.62