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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