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Maine 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 $20 · 10th–90th $20–$270%20%40%90th$20Professionalmedian $33 · 10th–90th $21–$620%10%10th90th$33$20.0$50.0$100.0

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
$20.42 / $20.42 / $26.92
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $29.51 / $57.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $37.15 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $40.74 / $72.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $41.69 / $64.57
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $29.51 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $42.66 / $64.57