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Oklahoma 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 $3,548 · 10th–90th $112–$7,5860%10%10th90th$3,548Professionalmedian $74 · 10th–90th $43–$1170%10%20%10th90th$74$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
$501.19 / $2,089.30 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $72.44 / $117.49
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $100.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $5,754.40 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $77.62 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $67.61 / $114.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $93.33 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $83.18 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $602.56 / $1,584.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $61.66 / $91.20