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Tennessee 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
$146.72 / $2,133.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.14 / $74.44 / $110.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.00 / $148.00 / $1,676.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.14 / $83.95 / $130.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.50 / $87.24 / $167.52
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $266.76 / $266.76
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.88 / $472.88 / $6,230.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $794.00 / $2,577.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.70 / $100.29 / $220.13