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Nebraska 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 $4,365 · 10th–90th $132–$22,3870%10%10th90th$4,365Professionalmedian $81 · 10th–90th $39–$5250%10%10th90th$81$50.0$200.0$1.0K$5.0K$20.0K

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
$173.78 / $7,585.78 / $32,359.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $77.62 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,365.16 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $229.09
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $109.65 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $158.49 / $3,388.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $147.91 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $134.90 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $100.00 / $190.55