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Indiana rates for HCPCS 15275

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

Facilitymedian $4,365 · 10th–90th $126–$10,0000%10%10th90th$4,365Professionalmedian $138 · 10th–90th $78–$2950%10%20%10th90th$138$10.0$50.0$200.0$1.0K$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
$109.65 / $2,089.30 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $131.83 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $46.77 / $158.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $8,317.64 / $10,471.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $141.25 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $213.80 / $338.84
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $109.65 / $123.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $162.18 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $134.90 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $147.91 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $3,715.35 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $138.04 / $234.42