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Skin Substitute, Trunk/Arms/Legs, First 100 sq cm

Wisconsin 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

Rates data updated July 2026.

Facilitymedian $4,677 · 10th–90th $3,020$7,0790%10%10th90th$4,677Professionalmedian $65 · 10th–90th $55$710%20%10th90th$65$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$4,677.35
Typical High
$7,079.46
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,265.80
Typical High
$6,309.57
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$64.57
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$4,265.80
Typical High
$4,570.88
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
United
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$8,128.31