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Connecticut rates for HCPCS 15278

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; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.45 / $4,228.00 / $10,492.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.46 / $73.95 / $136.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,806.00 / $15,066.00 / $22,422.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.88 / $83.82 / $125.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.07 / $108.49 / $183.15
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.34 / $101.58 / $106.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.00 / $3,983.00 / $6,832.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.91 / $114.48 / $191.05