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Texas 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 $2,570 · 10th–90th $724–$7,0790%5%10th90th$2,570Professionalmedian $794 · 10th–90th $603–$1,3490%10%10th90th$794$50.0$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
$724.44 / $2,951.21 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $776.25 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,630.27 / $5,011.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $870.96 / $1,258.93
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $933.25 / $1,412.54
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $28,840.32 / $28,840.32
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,888.44 / $6,918.31 / $6,918.31
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $3,981.07
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,071.52 / $1,737.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $645.65
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $851.14 / $1,318.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $954.99 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $2,041.74 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $794.33 / $1,148.15
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $891.25