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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
$27.78 / $784.00 / $1,831.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.10 / $31.20 / $48.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.00 / $94.00 / $94.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.60 / $39.68 / $64.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $529.00 / $1,739.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.06 / $36.88 / $81.27