go back

North Dakota 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
$25.58 / $33.88 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.26 / $27.91 / $33.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.66 / $62.51 / $79.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.90 / $60.76 / $84.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.58 / $34.50 / $76.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.36 / $62.15 / $2,210.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.36 / $58.36 / $73.12