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Arizona 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 $2,884 · 10th–90th $1,175–$6,7610%5%10%10th90th$2,884Professionalmedian $759 · 10th–90th $589–$1,9500%10%10th90th$759$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
$1,737.80 / $3,715.35 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $758.58 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $2,454.71 / $4,570.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $676.08 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $776.25 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $3,235.94
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $870.96 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,737.80 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $758.58 / $1,122.02