go back

Pennsylvania 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
$594.00 / $2,747.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $37.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,247.70 / $1,247.70 / $1,247.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $2,679.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $2,605.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.00 / $674.00 / $4,300.00