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Maine 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

Professionalmedian $912 · 10th–90th $575–$1,6980%10%10th90th$912$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
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $812.83 / $1,698.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $977.24 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,023.29 / $1,778.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,047.13 / $1,778.28
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $794.33 / $1,737.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,047.13 / $1,778.28