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Maryland 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 $447 · 10th–90th $447–$7080%50%90th$447Professionalmedian $724 · 10th–90th $589–$1,4130%10%10th90th$724$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $707.95 / $1,412.54
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $724.44 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $851.14 / $1,445.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $812.83 / $1,412.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $1,412.54