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Nebraska 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 $4,365 · 10th–90th $1,318–$8,5110%10%10th90th$4,365Professionalmedian $1,072 · 10th–90th $617–$3,8020%5%10%10th90th$1,072$1.0K$2.0K$5.0K$10.0K$20.0K

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 / $5,011.87 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $870.96 / $3,801.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,365.16 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,148.15 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,778.28 / $2,344.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,412.54 / $4,897.79
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,659.59 / $6,025.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,819.70 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,778.28 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,090.30 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,445.44 / $1,862.09