go back

Minnesota 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 / $29.50 / $2,525.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $29.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$816.22 / $1,396.23 / $2,539.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.50 / $1,438.00 / $2,400.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.00 / $1,749.00 / $2,883.00