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Montana 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 $36 · 10th–90th $28–$470%20%40%10th90th$36Professionalmedian $28 · 10th–90th $15–$600%20%10th90th$28$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$14.79 / $24.55 / $60.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $33.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $26.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $30.20 / $44.67
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $36.31 / $45.71
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $36.31 / $45.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $22.39 / $40.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $36.31 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $33.11 / $47.86