go back

Kentucky rates for HCPCS C5272

Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.00 / $787.00 / $8,229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $36.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.01 / $8.01 / $8.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.00 / $597.00 / $1,895.00