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Missouri 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 $1,820 · 10th–90th $100–$5,6230%5%10th90th$1,820Professionalmedian $71 · 10th–90th $39–$2290%10%10th90th$71$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
$60.26 / $2,511.89 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $70.79 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $63.10 / $117.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $83.18 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $128.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $89.13 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $102.33 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $707.95 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $69.18 / $109.65