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Missouri 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 $1,820 · 10th–90th $135–$5,4950%5%10%10th90th$1,820Professionalmedian $151 · 10th–90th $81–$3890%10%20%10th90th$151$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
$114.82 / $2,344.23 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $144.54 / $467.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $141.25 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$138.04 / $208.93 / $363.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $158.49 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $162.18 / $257.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $190.55 / $2,630.27
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $204.17 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,148.15 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $144.54 / $234.42