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Maine 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)

Professionalmedian $66 · 10th–90th $40–$1410%10%10th90th$66$50.0$100.0$200.0

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
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $61.66 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $75.86 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $95.50 / $177.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $91.20 / $165.96
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $61.66 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $85.11 / $151.36