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South Carolina 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 / $7,182.00 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $37.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.19 / $905.66 / $1,442.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$536.76 / $536.76 / $536.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.50 / $29.50 / $39.83
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.30 / $427.30 / $427.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $1,221.00 / $3,585.00