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Delaware 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
$3,949.00 / $3,949.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.27 / $195.27 / $308.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.88 / $312.18 / $455.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.98 / $358.62 / $788.96