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Wyoming 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
$24.76 / $25.51 / $33.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.00 / $58.00 / $76.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.36 / $42.54 / $61.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.16 / $58.80 / $108.89