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New York rates for HCPCS 15278

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; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $3,090 · 10th–90th $112–$7,4130%10%10th90th$3,090Professionalmedian $85 · 10th–90th $49–$2190%10%20%10th90th$85$20.0$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
$83.18 / $2,884.03 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $229.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,630.78 / $5,011.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $85.11 / $204.17
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $1,258.93 / $6,165.95
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $95.50 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $102.33 / $229.09
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $58.88 / $138.04
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $144.54 / $213.80
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $173.78
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,511.89 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $91.20 / $234.42
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $58.88 / $104.71
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $100.00 / $173.78