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Maryland 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 $4,169 · 10th–90th $447–$4,1690%50%10th$4,169Professionalmedian $295 · 10th–90th $195–$5890%10%10th90th$295$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $295.12 / $602.56
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $229.09 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $323.59 / $575.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $426.58 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $309.03 / $524.81
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $380.19 / $588.84