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Louisiana 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 $1,148 · 10th–90th $81–$3,4670%10%10th90th$1,148Professionalmedian $63 · 10th–90th $39–$1170%10%20%10th90th$63$0.0$0.2$2.0$20.0$200.0$2.0K

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
$85.11 / $1,288.25 / $3,715.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $63.10 / $138.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $426.58 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $74.13 / $89.13
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $66.07 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $562.34 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $66.07 / $107.15