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Nationwide rates for HCPCS C5278

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; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,192.00 / $3,007.00 / $7,572.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,168.50 / $2,741.50 / $7,426.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,139.00 / $2,282.50 / $3,118.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.01 / $8.01 / $8.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$644.92 / $1,110.00 / $1,110.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.50 / $1,189.50 / $2,699.00