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Arizona rates for HCPCS C5276

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; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)

Facilitymedian $1,175 · 10th–90th $302–$2,1380%5%10%10th90th$1,175Professionalmedian $28 · 10th–90th $18–$1020%10%20%10th90th$28$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$275.42 / $1,230.27 / $2,238.72
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $27.54 / $102.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,412.54 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $707.95 / $1,584.89