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North Carolina 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 $110 · 10th–90th $45–$5,2480%5%10%10th90th$110Professionalmedian $78 · 10th–90th $40–$2630%10%10th90th$78$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
$44.67 / $120.23 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $75.86 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $93.33 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $81.28 / $151.36
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $67.61 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $831.76 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $66.07 / $120.23
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $275.42 / $275.42
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13