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Maryland 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 $129 · 10th–90th $1–$1510%20%40%10th90th$129Professionalmedian $29 · 10th–90th $21–$580%10%10th90th$29$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.98 / $0.98 / $0.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $28.84 / $57.54
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $26.30 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $57.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $39.81 / $69.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $56.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $35.48 / $54.95