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North Carolina 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 / $1,615.00 / $7,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $36.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.00 / $37.79 / $43.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.00 / $896.00 / $2,229.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00