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Oregon 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 $661 · 10th–90th $355–$6,0260%20%10th90th$661Professionalmedian $372 · 10th–90th $191–$7760%5%10%10th90th$372$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
$446.68 / $758.58 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $295.12 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $512.86 / $891.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $478.63 / $870.96
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $446.68 / $812.83
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $537.03 / $831.76
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $660.69 / $691.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $426.58 / $758.58
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $512.86 / $851.14
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $6,309.57 / $7,762.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $575.44 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $6,309.57 / $8,912.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $489.78 / $851.14