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Louisiana 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 $1,778 · 10th–90th $741–$5,3700%5%10th90th$1,778Professionalmedian $832 · 10th–90th $603–$1,4450%10%10th90th$832$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
$676.08 / $1,513.56 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $831.76 / $1,479.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $4,786.30 / $7,079.46
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $831.76 / $1,023.29
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $891.25 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $3,630.78 / $8,912.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $794.33 / $1,258.93