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Massachusetts 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
$1,486.00 / $2,670.00 / $3,693.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,089.00 / $3,372.00 / $8,498.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,089.00 / $3,372.00 / $8,498.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.00 / $3,372.00 / $8,425.00