go back

New York 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 $1,072–$9,1200%5%10th90th$3,890Professionalmedian $794 · 10th–90th $603–$2,0420%10%10th90th$794$100.0$500.0$2.0K$10.0K$50.0K

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
$954.99 / $3,162.28 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $758.58 / $2,041.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,772.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $794.33 / $1,862.09
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,698.24 / $6,165.95
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $4,786.30 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,023.29 / $2,290.87
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $812.83 / $2,511.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,202.26 / $1,819.70
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $1,479.11
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,071.52 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,467.37 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $870.96 / $1,995.26
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $741.31 / $2,238.72
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $2,137.96