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Utah rates for HCPCS 15040

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

Facilitymedian $3,388 · 10th–90th $257$4,8980%10%20%10th90th$3,388Professionalmedian $331 · 10th–90th $151$5370%10%10th90th$331$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $3,388.44 / $4,897.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,548.13 / $5,495.41
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $331.13 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61