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Oklahoma 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 $4,677 · 10th–90th $832–$10,7150%5%10%10th90th$4,677Professionalmedian $813 · 10th–90th $617–$1,3800%10%10th90th$813$200.0$1.0K$5.0K$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
$812.83 / $2,570.40 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $812.83 / $1,412.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $7,943.28 / $12,882.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $831.76 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $933.25 / $1,230.27
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,000.00 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $891.25 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,995.26 / $3,801.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $741.31 / $1,023.29