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Minnesota 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
$51.35 / $92.72 / $2,168.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.35 / $89.40 / $142.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $44.06 / $488.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.78 / $166.18 / $306.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.78 / $327.27 / $787.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.06 / $199.12 / $388.91
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.72 / $299.20 / $619.92
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.31 / $193.30 / $358.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.50 / $107.22 / $241.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.00 / $178.27 / $402.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.00 / $1,749.00 / $2,883.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.00 / $149.36 / $347.47