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Pennsylvania 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 $2,692 · 10th–90th $479–$8,3180%5%10%10th90th$2,692Professionalmedian $22 · 10th–90th $15–$870%20%10th90th$22$10.0$50.0$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
$537.03 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $21.88 / $95.50
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $41.69 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $25.70 / $42.66
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $39.81 / $43.65
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $31.62 / $43.65
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $21.88 / $45.71
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $45.71 / $107.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $16.98 / $75.86
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $23.44 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $25.12 / $42.66