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Alaska rates for HCPCS 15274

Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $219 · 10th–90th $38–$9,7720%5%10%10th90th$219Professionalmedian $107 · 10th–90th $40–$2570%5%10th90th$107$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $5,888.44 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $77.62 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $85.11 / $251.19
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $117.49 / $380.19
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $151.36 / $275.42
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $239.88 / $331.13
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $85.11 / $380.19
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $85.11 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $109.65 / $199.53