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New Jersey 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 $4,786 · 10th–90th $1,259–$10,7150%10%10th90th$4,786Professionalmedian $71 · 10th–90th $38–$2190%5%10%10th90th$71$20.0$100.0$500.0$2.0K$10.0K

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
$1,000.00 / $5,370.32 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $69.18 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $75.86 / $144.54
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $102.33 / $141.25
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $77.62 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,630.27 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $56.23 / $128.82