CPT 95115: Allergen Immunotherapy, Single Injection
Medicare pays $11 and commercial payers pay $42 on average nationally for this procedure.
CPT code 95115 describes a single allergen immunotherapy injection given by a provider to desensitize a patient to a specific allergen; this is a professional injection service typically delivered in an outpatient clinic or office setting during a single visit.
For related coverage guidance, see recent payer policy updates: Diagnosis of Idiopathic Environmental Intolerance, Allergen Testing, Allergen Testing.
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National Reimbursement Benchmarks
National averages show a clear split: Medicare’s mean rate of $10.7 sits well below BUCA’s average commercial mean of $42.1, indicating that commercial arrangements captured by BUCA pay roughly four times Medicare on average for CPT 95115. Blue Cross Blue Shield and UnitedHealth Group also post higher means ($63.2 and $15.4 respectively) than Medicare, while Aetna and Cigna cluster closer to Medicare’s level.
Dispersion varies notably across payers. Blue Cross Blue Shield has one of the widest interquartile spreads with P75–P25 = $24.5, signaling greater variability in contract rates, while Aetna’s spread is tighter at $7.0. UnitedHealth Group and Cigna show moderate spreads of $9.1 and $8.2 respectively. BUCA’s interquartile spread is $14.5 and Medicare’s is narrow at $1.0, indicating relatively consistent local Medicare rates.