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Mississippi 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
$600.54 / $1,250.00 / $1,831.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,655.71 / $1,655.71 / $1,821.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.00 / $557.00 / $557.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,014.96 / $1,014.96 / $2,447.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$610.00 / $1,354.00 / $4,939.00