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Pedicle Flap On Eyelid, Nose, Ear Or Lip

Washington rates for HCPCS 15576

Creates a flap of skin and underlying tissue that stays attached at one end so it keeps its own blood supply, and moves it to cover a defect on the eyelid, nose, ear, lip or inside the mouth. Keeping the attachment lets the moved tissue survive while it grows into its new bed. A later operation to divide the attachment is sometimes needed.

Rates data updated October 2026.

How much does Pedicle Flap On Eyelid, Nose, Ear Or Lip cost?

$851

Typical negotiated rate. In Washington, October 2026.

Insurers have agreed to pay about $851 for this service. The price depends on where it is billed: about $813 from a physician practice, and about $1,349 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 10 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$813$204 to $1,175
FacilityA hospital or hospital-owned outpatient department$1,349$851 to $2,692

How much rates vary

Facilitymedian $1,349 · 10th to 90th $676 to $7,586Professionalmedian $813 · 10th to 90th $107 to $1,622
$100$1K$10Kfacility $1,349professional $813

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$851.14
Median
$8,912.51
Typical High
$21,877.62
Aetna
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$870.96
Typical High
$1,122.02
Asuris Northwest Health
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$1,513.56
Typical High
$7,079.46
Asuris Northwest Health
Setting
Professional
Modifier
None
Typical Low
$891.25
Median
$1,513.56
Typical High
$6,760.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$1,548.82
Typical High
$2,818.38
Cigna
Setting
Professional
Modifier
None
Typical Low
$794.33
Median
$954.99
Typical High
$1,778.28
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$1,023.29
Median
$1,584.89
Typical High
$2,344.23
Molina
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$524.81
Typical High
$1,513.56
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$1,445.44
Typical High
$1,584.89
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$794.33
Median
$1,047.13
Typical High
$1,862.09
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$891.25
Median
$891.25
Typical High
$1,071.52
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$4,073.80
Median
$5,370.32
Typical High
$10,000.00
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$891.25
Median
$1,071.52
Typical High
$1,659.59
United
Setting
Facility
Modifier
None
Typical Low
$588.84
Median
$977.24
Typical High
$8,128.31
United
Setting
Professional
Modifier
None
Typical Low
$812.83
Median
$1,047.13
Typical High
$2,041.74
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$575.44
Median
$812.83
Typical High
$1,174.90
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$426.58
Median
$457.09
Typical High
$524.81
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$169.82
Median
$181.97
Typical High
$208.93
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$630.96
Median
$691.83
Typical High
$776.25
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$125.89
Median
$138.04
Typical High
$158.49
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$85.11
Median
$91.20
Typical High
$104.71
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$588.84
Median
$645.65
Typical High
$724.44

Where Washington sits

The same service costs 4.5 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington· 29th of 51

$851

AK $2,630TX $589

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.