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Utah 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 $3,162 · 10th–90th $83–$4,5710%10%20%10th90th$3,162Professionalmedian $87 · 10th–90th $50–$2450%10%10th90th$87$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$83.18 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $85.11 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $95.50 / $151.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $204.17
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $100.00 / $141.25
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $109.65 / $141.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $79.43 / $123.03