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Delaware rates for HCPCS 15276

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; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,140.00 / $3,140.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.10 / $22.07 / $29.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.58 / $35.47 / $49.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.68 / $42.33 / $96.94