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Iowa 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 $4,467 · 10th–90th $1,023–$12,0230%10%10th90th$4,467Professionalmedian $977 · 10th–90th $617–$3,0200%10%20%10th90th$977$0.5$5.0$50.0$500.0$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
$1,023.29 / $4,265.80 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $933.25 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,949.84 / $2,454.71
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,122.02 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,949.84 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,621.81 / $5,128.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,862.09 / $2,290.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,762.47 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,071.52 / $1,995.26
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,445.44 / $1,778.28