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Massachusetts 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
$64.19 / $2,079.00 / $3,625.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.78 / $64.19 / $108.45
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.19 / $627.00 / $2,733.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.57 / $131.68 / $394.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.17 / $82.12 / $144.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.50 / $111.71 / $250.17
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.37 / $168.26 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.38 / $130.19 / $179.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.40 / $143.13 / $255.85
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $966.90 / $3,445.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.20 / $150.63 / $6,230.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$627.00 / $1,818.00 / $2,733.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.35 / $136.35 / $286.77