go back

Alabama rates for HCPCS 15277

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,445.44 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $309.03 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $3,235.94 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $229.09 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $288.40 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $1,698.24 / $3,090.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $269.15 / $371.54