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Washington 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 $68 · 10th–90th $39–$9,7720%10%20%10th90th$68Professionalmedian $36 · 10th–90th $21–$740%10%20%10th90th$36$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$44.67 / $89.13 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $30.90 / $66.07
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $48.98 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $51.29 / $89.13
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $53.70 / $79.43
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $54.95 / $79.43
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $56.23
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $64.57 / $66.07
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $44.67
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $47.86 / $81.28
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $251.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $48.98 / $77.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $645.65 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $45.71 / $79.43
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $45.71 / $70.79