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Nevada 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
$649.01 / $2,173.00 / $4,730.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.58 / $27.58 / $27.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,779.00 / $3,647.00 / $4,098.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.41 / $345.41 / $345.41
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.00 / $200.00 / $200.00
Hometown Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.51 / $676.51 / $676.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $1,427.00 / $1,998.00