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Oklahoma 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
$1,000.00 / $3,165.00 / $8,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $37.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,878.46 / $6,117.46 / $9,735.10
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 / $100.00 / $1,530.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $610.00 / $1,883.00