go back

Alabama rates for HCPCS C5275

Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.00 / $1,223.00 / $2,250.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.58 / $27.58 / $35.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,607.25 / $3,164.02 / $4,256.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.00 / $850.00 / $1,349.00