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North Dakota 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 $78 · 10th–90th $40–$8,5110%20%10th90th$78Professionalmedian $87 · 10th–90th $40–$1740%10%10th90th$87$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$39.81 / $77.62 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $128.82 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $79.43 / $134.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $131.83 / $2,951.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $85.11 / $162.18