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California rates for HCPCS 15277

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Facilitymedian $4,677 · 10th–90th $1,514–$13,4900%10%10th90th$4,677Professionalmedian $295 · 10th–90th $186–$1,0720%10%20%10th90th$295$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
$2,137.96 / $6,309.57 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $288.40 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $4,570.88 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $302.00 / $707.95
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $4,466.84 / $8,912.51
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $338.84 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $338.84 / $616.60
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $257.04 / $512.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $380.19 / $691.83
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $6,309.57
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,884.03 / $2,884.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $478.63
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $309.03 / $524.81
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $346.74 / $676.08
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $1,122.02
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $288.40 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $4,265.80 / $9,549.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $302.00 / $645.65