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North Dakota 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 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $29.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.50 / $29.50 / $88.50