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New Mexico 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 / $5,000.27 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $29.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.63 / $2,088.69 / $3,403.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $386.77
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.50 / $29.50 / $29.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.00 / $1,158.00 / $1,401.00