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Nevada 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,173.00 / $4,841.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.17 / $3,959.00 / $10,300.00
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
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $1,427.00 / $1,998.00