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New Mexico 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 $891 · 10th–90th $316–$7,7620%10%20%10th90th$891Professionalmedian $339 · 10th–90th $209–$6030%10%20%10th90th$339$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$316.23 / $575.44 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $338.84 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,819.70 / $2,884.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $295.12 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $338.84 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $57.54 / $478.63
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $645.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $371.54 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $4,073.80 / $8,912.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $398.11 / $588.84