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Skin Substitute, Trunk/Arms/Legs, Add-On 100 sq cm

Nationwide rates for HCPCS C5274

Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)

Rates data updated October 2026.

How much does Skin Substitute, Trunk/Arms/Legs, Add-On 100 sq cm cost?

$871

Typical negotiated rate. Nationwide, October 2026.

Insurers have agreed to pay about $871 for this service. The price depends on where it is billed: about $63.10 from a physician practice, and about $1,047 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$63.10$38.02 to $72.44
FacilityA hospital or hospital-owned outpatient department$1,047$372 to $2,754

How much rates vary

Facilitymedian $1,047 · 10th to 90th $200 to $3,981Professionalmedian $63 · 10th to 90th $38 to $87
$50$200$1K$5Kfacility $1,047professional $63

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$933.25
Median
$3,162.28
Typical High
$4,897.79
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$660.69
Typical High
$1,737.80
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$54.95
Typical High
$81.28
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$1.00
Median
$1.00
Typical High
$1.00
CDPHP
Setting
Facility
Modifier
None
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$6,165.95
Hally Health
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$151.36
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$199.53
Typical High
$407.38
Medica
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$398.11
Typical High
$1,698.24
Network Health
Setting
Facility
Modifier
None
Typical Low
$831.76
Median
$954.99
Typical High
$2,344.23
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$954.99
Typical High
$2,187.76

What it costs in each state

The same service costs 26.3 times more in New York than in California. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Touch or drag across the chart to see any state's rate.

NY $3,162CA $120

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.