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Arkansas 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
$920.00 / $1,688.00 / $3,804.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,305.00 / $1,305.00 / $1,846.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.00 / $1,230.00 / $2,558.00