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Connecticut 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
$3,361.58 / $4,908.03 / $8,031.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,217.00 / $8,931.00 / $11,908.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.01 / $8.01 / $8.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,674.74 / $1,674.74 / $1,674.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,414.00 / $5,950.00 / $9,338.00