go back

Alabama rates for HCPCS C5273

Application Of Low Cost Skin Substitute Graft To Trunk Arms Legs Total Wound Surface Area Greater Than Or Equal To 100 Sq Cm; First 100 Sq Cm Wound Surface Area Or 1% Of Body Area Of Infants And Children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.00 / $1,251.00 / $2,250.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,607.25 / $3,164.02 / $4,256.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.00 / $1,738.00 / $3,362.00