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Illinois 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 $1,380 · 10th–90th $87–$5,6230%5%10th90th$1,380Professionalmedian $76 · 10th–90th $39–$2240%5%10%10th90th$76$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
$87.10 / $1,412.54 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $72.44 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $524.81 / $1,000.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $83.18 / $134.90
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
$47.86 / $81.28 / $138.04
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $120.23 / $354.81
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $56.23 / $109.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $851.14 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $77.62 / $138.04