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Hawaii 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 $3,890 · 10th–90th $1,514–$3,8900%50%10th$3,890Professionalmedian $955 · 10th–90th $617–$4,8980%10%10th90th$955$50.0$200.0$1.0K$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
$1,513.56 / $3,890.45 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $758.58 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,023.29 / $1,230.27
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,348.96 / $7,943.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $977.24 / $1,174.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $891.25 / $1,096.48
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $2,041.74 / $5,370.32