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Ohio rates for HCPCS 15040

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

Facilitymedian $3,020 · 10th–90th $245$10,2330%5%10th90th$3,020$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $3,388.44 / $10,715.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,187.76 / $7,943.28
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,570.40 / $5,754.40