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Michigan 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 $2,042 · 10th–90th $55–$4,8980%20%10th90th$2,042Professionalmedian $71 · 10th–90th $38–$1910%5%10%10th90th$71$10.0$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
$54.95 / $2,041.74 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $70.79 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $64.57 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $70.79 / $199.53
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $2,041.74 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $83.18 / $151.36
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $61.66 / $89.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,258.93 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $74.13 / $100.00