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Pennsylvania 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 $955–$8,3180%5%10%10th90th$3,890Professionalmedian $708 · 10th–90th $575–$1,3490%20%10th90th$708$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
$954.99 / $3,890.45 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $1,288.25
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,174.90 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $794.33 / $1,348.96
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,318.26 / $1,445.44
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $954.99 / $1,412.54
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $691.83 / $1,445.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,584.89 / $5,495.41
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $707.95 / $776.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $707.95 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $4,897.79 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $812.83 / $1,479.11