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Nebraska 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 $4,266 · 10th–90th $513–$8,5110%10%10th90th$4,266Professionalmedian $457 · 10th–90th $209–$1,1750%5%10%10th90th$457$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$724.44 / $5,011.87 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $407.38 / $1,174.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,365.16 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $398.11 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $645.65 / $977.24
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $549.54 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $691.83 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $691.83 / $954.99
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $676.08 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,090.30 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $489.78 / $794.33