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New Mexico 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 $214 · 10th–90th $35–$7,7620%10%10th90th$214Professionalmedian $33 · 10th–90th $21–$620%10%20%10th90th$33$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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 / $53.70 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $30.90 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $436.52 / $707.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.90 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $37.15 / $52.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $32.36 / $46.77
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $33.11 / $60.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $39.81 / $56.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $1,148.15 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $44.67 / $60.26