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Maryland 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 $302 · 10th–90th $91–$2,4550%10%20%10th90th$302Professionalmedian $135 · 10th–90th $78–$2750%10%20%10th90th$135$1.0$5.0$20.0$100.0$500.0$2.0K

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
$91.20 / $302.00 / $2,454.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $134.90 / $275.42
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $95.50 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $251.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $144.54 / $245.47
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $169.82 / $263.03