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North Dakota 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
$95.72 / $158.15 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.79 / $131.59 / $158.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.10 / $306.24 / $386.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.00 / $281.30 / $495.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.72 / $158.15 / $287.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.68 / $267.98 / $3,179.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.68 / $253.10 / $341.34