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Arizona 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

Facilitymedian $1,778 · 10th–90th $550–$3,8900%5%10th90th$1,778Professionalmedian $112 · 10th–90th $79–$3800%10%20%10th90th$112$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $2,454.71 / $4,570.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $112.20 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $954.99 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $707.95 / $1,584.89