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Maine rates for HCPCS 15272

Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $240 · 10th–90th $35–$2400%50%10th$240Professionalmedian $25 · 10th–90th $15–$470%10%10th90th$25$10.0$20.0$50.0$100.0$200.0

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
$35.48 / $239.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $22.91 / $42.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.92 / $39.81
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$28.18 / $40.74 / $63.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $30.20 / $54.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $31.62 / $50.12
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $23.44 / $51.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $31.62 / $48.98