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Ohio 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 $148–$8,3180%10%10th90th$2,291Professionalmedian $151 · 10th–90th $81–$3160%10%20%10th90th$151$1.0$10.0$100.0$1.0K$10.0K$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
$138.04 / $2,290.87 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $138.04 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $102.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,884.03 / $7,943.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $154.88 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$151.36 / $234.42 / $363.08
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $114.82 / $123.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $154.88 / $269.15
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,089.30 / $3,235.94
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $154.88 / $263.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $66.07
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $457.09
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $158.49 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $2,290.87 / $5,248.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $141.25 / $229.09