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Washington rates for HCPCS 15150

Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less

Facilitymedian $1,585 · 10th–90th $955–$10,7150%10%10th90th$1,585Professionalmedian $912 · 10th–90th $562–$1,7780%10%10th90th$912$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
$1,202.26 / $1,778.28 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $758.58 / $1,621.81
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,897.79 / $10,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,230.27 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $912.01 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,148.15 / $1,995.26
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,380.38 / $2,511.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,380.38 / $1,905.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $281.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,348.96 / $1,412.54
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $977.24
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,202.26 / $1,862.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,011.87 / $10,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,230.27 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $6,456.54 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $954.99 / $1,819.70
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $870.96 / $1,258.93