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Maine 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 $2,291 · 10th–90th $1–$4,7860%20%10th90th$2,291Professionalmedian $141 · 10th–90th $83–$2690%10%20%10th90th$141$1.0$5.0$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
$0.93 / $2,290.87 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $128.82 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$154.88 / $239.88 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $186.21 / $354.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $186.21 / $309.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $131.83 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $186.21 / $323.59