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Montana 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

Facilitymedian $5,248 · 10th–90th $3,981–$5,6230%20%40%10th90th$5,248Professionalmedian $5,248 · 10th–90th $3,981–$5,6230%20%40%10th90th$5,248$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,248.07 / $5,623.41
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,248.07 / $5,623.41