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Minnesota 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 $257 · 10th–90th $40–$7080%10%10th90th$257Professionalmedian $112 · 10th–90th $46–$2450%10%10th90th$112$1.0$5.0$20.0$100.0$500.0$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
$39.81 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $64.57 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $275.42 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $138.04 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $295.12 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $173.78 / $331.13
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $275.42 / $549.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $158.49 / $281.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $93.33 / $562.34
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $2,951.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $2,089.30 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $114.82 / $245.47