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Montana rates for HCPCS 15040

Harvest of skin for tissue cultured skin autograft, 100 sq cm or less

Facilitymedian $275 · 10th–90th $214$4790%20%10th90th$275$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
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $426.58 / $489.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $223.87 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74