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Pennsylvania 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 $2,692 · 10th–90th $398–$8,3180%5%10th90th$2,692Professionalmedian $68 · 10th–90th $39–$1780%20%10th90th$68$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$398.11 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $67.61 / $229.09
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $128.82 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $74.13 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $134.90 / $151.36
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $141.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $70.79 / $154.88
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $125.89 / $281.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $52.48 / $61.66
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $56.23 / $77.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $69.18 / $120.23