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Arizona 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 $2,138 · 10th–90th $229–$5,6230%5%10%10th90th$2,138Professionalmedian $68 · 10th–90th $38–$2140%10%10th90th$68$50.0$100.0$200.0$500.0$1.0K$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,818.38 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $229.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $1,230.27 / $2,238.72
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $54.95 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $69.18 / $104.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $75.86 / $1,905.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,122.02 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $64.57 / $100.00