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Nationwide rates for HCPCS C5277

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 greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $3,388.44 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $50,118.72 / $53,703.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $616.60 / $2,089.30