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Utah rates for HCPCS 15050

Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter

Facilitymedian $3,236 · 10th–90th $575–$4,8980%10%10th90th$3,236Professionalmedian $550 · 10th–90th $389–$8910%10%10th90th$550$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $3,388.44 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $537.03 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $676.08 / $933.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,122.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,202.26 / $1,819.70
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $724.44 / $1,023.29
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $724.44 / $912.01
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $691.83 / $977.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $537.03 / $812.83