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New Jersey 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
$37.43 / $5,009.00 / $9,842.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $37.43 / $37.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.99 / $1,346.67 / $2,641.30
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.50 / $30.00 / $30.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,529.00 / $3,352.00 / $10,536.00