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Vermont 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
Professional
Modifier
Low / Median / High Price
$57.56 / $91.66 / $151.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.83 / $100.01 / $274.06
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.42 / $127.58 / $274.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.29 / $131.05 / $380.98