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Missouri 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 $2,188 · 10th–90th $302–$5,6230%5%10th90th$2,188Professionalmedian $309 · 10th–90th $195–$7240%10%10th90th$309$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
$251.19 / $3,162.28 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $309.03 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $295.12 / $512.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $363.08 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $346.74 / $562.34
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $416.87 / $2,630.27
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,659.59 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $316.23 / $512.86