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New Jersey 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
$27.95 / $4,294.00 / $9,860.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.10 / $28.57 / $51.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.72 / $35.36 / $64.08
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.52 / $45.43 / $50.94
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.03 / $35.93 / $53.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,529.00 / $3,352.00 / $10,536.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.02 / $32.96 / $70.31