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Mississippi 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
$26.92 / $954.99 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $28.18 / $47.86
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $93.33 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $37.15 / $64.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $588.84 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $33.88 / $61.66