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California 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 $6,026 · 10th–90th $2,089–$13,8040%5%10th90th$6,026Professionalmedian $871 · 10th–90th $646–$2,6300%10%10th90th$871$50.0$200.0$1.0K$5.0K$20.0K

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
$2,290.87 / $6,456.54 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $831.76 / $2,691.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $758.58 / $912.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $6,165.95 / $13,489.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,023.29 / $2,398.83
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $5,011.87 / $9,332.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $977.24 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $954.99 / $1,737.80
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $851.14 / $1,288.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $954.99 / $1,698.24
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $28,840.32 / $28,840.32
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,079.46 / $7,079.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $1,202.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $1,380.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $954.99 / $1,862.09
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $2,818.38
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $794.33 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $9,772.37 / $20,417.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $831.76 / $1,698.24