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Wound Bed Preparation, Face/Hands/Feet

Utah 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 $2,884 · 10th–90th $407$4,7860%10%10th90th$2,884Professionalmedian $407 · 10th–90th $234$1,3800%10%10th90th$407$50.0$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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$3,162.28
Typical High
$4,786.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$407.38
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$436.52
Typical High
$630.96
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$691.83
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,230.27
Typical High
$1,819.70
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$436.52
Typical High
$630.96
Select Health
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Select Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$295.12
Typical High
$575.44
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$489.78
Typical High
$794.33
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$4,466.84
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$346.74
Typical High
$562.34