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Indiana 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 $2,188 · 10th–90th $35–$5,6230%5%10%10th90th$2,188Professionalmedian $29 · 10th–90th $21–$590%10%10th90th$29$20.0$100.0$500.0$2.0K

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
$35.48 / $3,467.37 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $28.18 / $61.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $2,187.76 / $3,388.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $33.88 / $52.48
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $36.31 / $52.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,290.87 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $32.36 / $53.70