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Maryland 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 $1,023 · 10th–90th $1,023–$2,2390%50%90th$1,023Professionalmedian $741 · 10th–90th $562–$1,4130%10%10th90th$741$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $741.31 / $1,380.38
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $758.58 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,412.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,023.29 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $794.33 / $1,445.44
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $1,380.38