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Illinois 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 $1,380 · 10th–90th $48–$5,6230%5%10%10th90th$1,380Professionalmedian $32 · 10th–90th $21–$600%20%10th90th$32$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$47.86 / $1,621.81 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $30.20 / $60.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $281.84 / $537.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $38.02 / $56.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $38.90 / $60.26
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $52.48 / $181.97
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $31.62 / $44.67
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $851.14 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $38.02 / $64.57