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Virginia 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 $62 · 10th–90th $27–$5,8880%10%10th90th$62Professionalmedian $31 · 10th–90th $22–$580%20%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
$32.36 / $812.83 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $28.84 / $48.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $37.15 / $56.23
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $28.18 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $34.67 / $58.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $39.81 / $46.77
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $50.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $34.67 / $4,073.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $45.71 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,047.13 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $33.88 / $57.54