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New Hampshire 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 $2,399 · 10th–90th $100–$9,7720%20%40%10th90th$2,399Professionalmedian $29 · 10th–90th $16–$580%5%10%10th90th$29$20.0$100.0$500.0$2.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $2,398.83 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $21.88 / $42.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $27.54 / $45.71
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$21.88 / $41.69 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $30.20 / $60.26
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $33.11 / $66.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $35.48 / $66.07