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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)

Rates data updated October 2026.

How much rates vary

Facilitymedian $501 · 10th to 90th $234 to $1,820Professionalmedian $26 · 10th to 90th $21 to $33
$20$50$100$200$500$1K$2Kfacility $501professional $26

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$660.69
Typical High
$1,737.80
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$20.89
Median
$26.30
Typical High
$33.11
Medica
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$354.81
Typical High
$1,949.84