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Oregon 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 $145 · 10th–90th $69–$5,0120%10%20%10th90th$145Professionalmedian $79 · 10th–90th $39–$2290%5%10th90th$79$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
$89.13 / $181.97 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $112.20 / $208.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $93.33 / $208.93
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $95.50 / $181.97
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $114.82 / $208.93
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $151.36 / $154.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $91.20 / $169.82
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $109.65 / $204.17
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $123.03 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $109.65 / $194.98