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Alaska rates for HCPCS 15115

Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

Facilitymedian $2,399 · 10th–90th $631–$9,7720%5%10th90th$2,399Professionalmedian $1,413 · 10th–90th $631–$2,8180%5%10%10th90th$1,413$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $7,079.46 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,047.13 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,148.15 / $2,630.27
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,148.15 / $4,897.79
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,137.96 / $2,884.03
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,951.21 / $3,388.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $4,897.79
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,071.52 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,230.27 / $2,818.38