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Arizona 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

Facilitymedian $1,820 · 10th–90th $550–$3,8900%5%10th90th$1,820Professionalmedian $245 · 10th–90th $191–$9120%10%10th90th$245$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
$158.49 / $245.47 / $912.01
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,122.02 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $707.95 / $1,584.89