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Pennsylvania 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 $3,890 · 10th–90th $955–$8,3180%5%10%10th90th$3,890Professionalmedian $288 · 10th–90th $195–$6030%10%10th90th$288$100.0$500.0$2.0K$10.0K$50.0K

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
$954.99 / $3,981.07 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $281.84 / $602.56
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $562.34 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $323.59 / $537.03
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $562.34 / $616.60
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $416.87 / $588.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $295.12 / $645.65
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $549.54 / $1,288.25
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $239.88 / $338.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $239.88 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $3,162.28 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $316.23 / $537.03