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Hawaii 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 $3,890 · 10th–90th $1,514–$3,8900%50%10th$3,890Professionalmedian $288 · 10th–90th $186–$6920%10%10th90th$288$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$1,513.56 / $3,890.45 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $288.40 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $436.52 / $524.81
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $489.78 / $2,630.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $380.19 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $363.08 / $446.68
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $251.19 / $426.58