go back

California 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 $4,169 · 10th–90th $933$13,1830%10%10th90th$4,169Professionalmedian $68 · 10th–90th $38$2630%10%20%10th90th$68$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
$1,122.02 / $5,754.40 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $446.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,466.84 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $70.79 / $165.96
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $1,174.90 / $2,511.89
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $75.86 / $138.04
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $50.12 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $89.13 / $169.82
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $275.42
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $114.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $66.07 / $125.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $147.91
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $257.04
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $93.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,584.89 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $67.61 / $141.25