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North Dakota 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
$56.37 / $92.46 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.35 / $81.62 / $92.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.80 / $141.63 / $218.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.57 / $161.40 / $239.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.37 / $92.46 / $169.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.28 / $151.78 / $402.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.75 / $143.34 / $199.56