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Hawaii 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 $2,884 · 10th–90th $1,000–$2,8840%50%10th$2,884Professionalmedian $29 · 10th–90th $21–$580%10%20%10th90th$29$10.0$50.0$200.0$1.0K

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
$1,000.00 / $2,884.03 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $28.84 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $40.74 / $48.98
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $44.67 / $51.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $38.02 / $45.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $37.15 / $48.98
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $28.84 / $38.90