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Vermont 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
Professional
Modifier
Low / Median / High Price
$19.95 / $30.20 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $38.02 / $95.50
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $53.70 / $53.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $45.71 / $79.43