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Arizona rates for HCPCS 15276

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; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $2,089 · 10th–90th $55–$5,6230%10%10th90th$2,089Professionalmedian $29 · 10th–90th $21–$620%20%10th90th$29$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
$407.38 / $2,398.83 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $28.84 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $1,230.27 / $2,238.72
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $26.30 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $32.36 / $53.70
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $35.48 / $1,905.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.90 / $2,570.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,122.02 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $31.62 / $46.77