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New Mexico 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 $550 · 10th–90th $132–$19,9530%10%10th90th$550Professionalmedian $148 · 10th–90th $78–$2880%10%20%10th90th$148$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$131.83 / $288.40 / $19,952.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $144.54 / $398.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $1,174.90 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $162.18 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $223.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $144.54 / $288.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $169.82 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $3,235.94 / $5,011.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $190.55 / $275.42