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Michigan 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 $2,042 · 10th–90th $38–$4,8980%20%10th90th$2,042Professionalmedian $31 · 10th–90th $21–$580%10%10th90th$31$10.0$50.0$200.0$1.0K$5.0K

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
$38.02 / $2,041.74 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $29.51 / $57.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $37.15 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $33.11 / $114.82
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $2,041.74 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $38.02 / $58.88
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $28.18 / $43.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,258.93 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $35.48 / $48.98