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Indiana 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 $6,457 · 10th–90th $851–$17,7830%5%10th90th$6,457Professionalmedian $794 · 10th–90th $589–$1,8620%10%10th90th$794$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$776.25 / $1,380.38 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $776.25 / $2,041.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $13,803.84 / $18,620.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $954.99 / $1,412.54
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $933.25 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $7,762.47 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,348.96