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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
$328.91 / $1,223.00 / $2,250.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.66 / $276.13 / $331.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,607.25 / $3,164.02 / $4,256.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.09 / $229.69 / $314.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.40 / $251.59 / $633.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.00 / $1,738.00 / $3,362.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.99 / $317.99 / $411.72