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Arizona rates for HCPCS 15155

Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less

Facilitymedian $3,090 · 10th–90th $1,288–$6,7610%10%10th90th$3,090Professionalmedian $724 · 10th–90th $575–$1,8200%10%20%10th90th$724$500.0$1.0K$2.0K$5.0K$10.0K

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 / $3,090.30 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $2,454.71 / $4,570.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $758.58 / $1,318.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $851.14 / $6,025.60
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $831.76 / $5,888.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,981.07 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $724.44 / $1,071.52