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Alaska rates for HCPCS 15120

Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)

Facilitymedian $2,042 · 10th–90th $603–$9,7720%5%10%10th90th$2,042Professionalmedian $1,318 · 10th–90th $661–$2,8180%10%10th90th$1,318$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $7,079.46 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $954.99 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,148.15 / $2,754.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,202.26 / $4,786.30
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,995.26 / $2,884.03
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,019.95 / $3,630.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $954.99 / $4,786.30
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,148.15 / $2,570.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,819.70 / $3,548.13