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Hawaii 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 $3,890 · 10th–90th $1,514–$3,8900%50%10th$3,890Professionalmedian $977 · 10th–90th $537–$4,8980%10%10th90th$977$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,513.56 / $3,890.45 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $691.83 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,000.00 / $1,202.26
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,174.90 / $1,412.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $977.24 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $870.96 / $1,122.02
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $2,041.74 / $5,370.32