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New Hampshire rates for HCPCS 15040

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

Facilitymedian $1,738 · 10th–90th $457–$9,7720%10%20%10th90th$1,738$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $2,398.83 / $9,772.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64