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Indiana 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
$29.50 / $1,386.00 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $37.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,111.00 / $4,320.00 / $9,270.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.96 / $439.96 / $439.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00