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Montana rates for HCPCS 15271

Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

Facilitymedian $209 · 10th–90th $141–$2950%20%10th90th$209Professionalmedian $145 · 10th–90th $78–$2690%10%20%10th90th$145$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$75.86 / $144.54 / $263.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $131.83 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $141.25 / $234.42
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $239.88 / $288.40
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $239.88 / $288.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $131.83 / $229.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $169.82 / $269.15