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Texas 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 $2,512 · 10th–90th $324–$6,3100%5%10th90th$2,512Professionalmedian $288 · 10th–90th $186–$5370%10%10th90th$288$50.0$200.0$1.0K$5.0K

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
$707.95 / $2,951.21 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $295.12 / $537.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $131.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,691.53 / $5,248.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $275.42 / $338.84
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $346.74 / $524.81
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $6,309.57
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,884.03 / $2,884.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $407.38 / $4,168.69
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $354.81 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $275.42
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $295.12 / $467.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $354.81 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $2,041.74 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $295.12 / $446.68
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $371.54