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Michigan 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 $2,884 · 10th–90th $275–$4,8980%20%10th90th$2,884Professionalmedian $295 · 10th–90th $191–$5250%10%10th90th$295$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$275.42 / $2,884.03 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $537.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $316.23 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $323.59 / $1,023.29
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $2,691.53 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $354.81 / $588.84
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,235.94 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $331.13 / $446.68