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Wound Bed Preparation, Face/Hands/Feet

Montana rates for HCPCS 15004

This procedure prepares a wound on the face, hands, feet, or genital area to receive a skin graft or wound covering by surgically cleaning and removing damaged tissue from the wound bed. It creates a healthy surface that will allow a subsequent graft to attach and heal properly.

Rates data updated July 2026.

Facilitymedian $589 · 10th–90th $437$8130%20%40%10th90th$589Professionalmedian $398 · 10th–90th $240$1,2020%10%20%10th90th$398$100.0$500.0$2.0K$10.0K$50.0K

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
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$363.08
Typical High
$1,202.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$457.09
Typical High
$660.69
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$660.69
Typical High
$724.44
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$660.69
Typical High
$724.44
Providence
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$363.08
Typical High
$660.69
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$416.87
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$501.19
Typical High
$724.44