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Idaho 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 $363 · 10th–90th $60–$5,4950%10%10th90th$363Professionalmedian $71 · 10th–90th $40–$1480%10%10th90th$71$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $67.61 / $128.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $263.03 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $131.83
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $74.13 / $144.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $97.72 / $173.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $93.33 / $154.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $79.43 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $8,317.64 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $77.62 / $125.89