go back

California rates for HCPCS C5271

Application Of Low Cost Skin Substitute Graft To Trunk Arms Legs Total Wound Surface Area Up To 100 Sq Cm; First 25 Sq Cm Or Less Wound Surface Area

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,539.00 / $6,218.00 / $17,013.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $37.43 / $323.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,491.00 / $4,604.00 / $6,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.01 / $8.01 / $8.01
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.30 / $100.00 / $1,904.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $120.00 / $393.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.50 / $37.43 / $53.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.00 / $1,572.00 / $5,830.00