go back

West Virginia 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
$54.95 / $89.13 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $67.61 / $97.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $72.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $95.50 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $91.20 / $436.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $457.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $83.18 / $134.90