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Michigan 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 $1,259 · 10th–90th $112–$4,8980%10%10th90th$1,259Professionalmedian $145 · 10th–90th $81–$3470%10%20%10th90th$145$0.5$2.0$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
$112.20 / $1,258.93 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $144.54 / $354.81
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $138.04 / $251.19
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $147.91 / $436.52
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $1,174.90 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $169.82 / $269.15
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $131.83 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,949.84 / $5,623.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $223.87