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Colorado 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
$1,532.00 / $3,716.25 / $9,888.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,575.67 / $1,575.67 / $1,575.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,434.00 / $5,126.00 / $9,729.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.01 / $8.01 / $8.01
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,575.67 / $1,654.45 / $2,647.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,577.00 / $4,182.00 / $7,179.00