go back

Wound Bed Preparation, Face/Hands/Feet

Ohio 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 $2,630 · 10th–90th $407$8,9130%10%10th90th$2,630Professionalmedian $363 · 10th–90th $229$7240%20%10th90th$363$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Facility
Modifier
Global
Typical Low
$407.38
Median
$3,162.28
Typical High
$9,120.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$338.84
Typical High
$2,818.38
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$112.20
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$2,137.96
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$371.54
Typical High
$602.56
CareSource
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$21,379.62
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$407.38
Typical High
$724.44
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$10,471.29
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$407.38
Typical High
$724.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$144.54
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$407.38
Typical High
$691.83
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$870.96
Typical High
$2,818.38
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$363.08
Typical High
$588.84