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Indiana 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 $2,188 · 10th–90th $60–$5,6230%5%10%10th90th$2,188Professionalmedian $68 · 10th–90th $38–$2340%10%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
$61.66 / $3,801.89 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $275.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $2,187.76 / $3,388.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $64.57 / $104.71
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $60.26 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $69.18 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,290.87 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $64.57 / $114.82