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Wyoming 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
Professional
Modifier
Low / Median / High Price
$222.66 / $225.42 / $346.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.00 / $602.00 / $803.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.81 / $398.64 / $584.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $5,606.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.44 / $587.41 / $963.61