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Tennessee 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 $1,202 · 10th–90th $151–$3,9810%10%10th90th$1,202Professionalmedian $71 · 10th–90th $38–$1780%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
$467.74 / $1,621.81 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $70.79 / $263.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $64.57 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $75.86 / $138.04
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $275.42 / $275.42
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $812.83 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $74.13 / $120.23