go back

Nevada 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
$1,210.00 / $2,173.00 / $4,841.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,575.67 / $3,959.00 / $10,300.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,214.00 / $3,931.00 / $5,258.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,032.25 / $1,032.25 / $1,032.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$721.00 / $2,200.00 / $6,317.00