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Massachusetts 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 $2,570 · 10th–90th $759–$5,6230%10%10th90th$2,570Professionalmedian $1,047 · 10th–90th $646–$2,2910%10%20%10th90th$1,047$1.0$10.0$100.0$1.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $2,754.23 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $870.96 / $2,290.87
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $5,754.40 / $28,840.32
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,096.48 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,513.56 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $2,238.72
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $3,630.78
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,174.90 / $1,513.56
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,248.07 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,202.26 / $2,290.87
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $758.58 / $2,951.21
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $5,754.40 / $28,840.32
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,096.48 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $5,248.07 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,148.15 / $2,290.87