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Virginia 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 $1,622 · 10th–90th $117–$7,4130%5%10%10th90th$1,622Professionalmedian $151 · 10th–90th $81–$2950%10%10th90th$151$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $2,187.76 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $144.54 / $295.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,981.07 / $4,466.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $158.49 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $239.88 / $389.05
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $102.33 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $239.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $223.87
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $144.54 / $234.42
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $131.83 / $4,073.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,090.30 / $5,370.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $147.91 / $263.03