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Idaho 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
$323.98 / $323.98 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $323.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.50 / $29.50 / $323.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,016.89 / $1,451.69 / $1,937.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00