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Georgia 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
$1,771.00 / $4,590.00 / $6,915.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,950.00 / $4,714.00 / $6,915.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$996.37 / $2,722.51 / $5,292.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.80 / $8.01 / $8.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.34 / $98.34 / $98.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,036.00 / $3,250.00 / $5,272.00