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Maryland 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 $2,455 · 10th–90th $56–$5,0120%20%10th90th$2,455Professionalmedian $813 · 10th–90th $603–$1,7380%10%10th90th$813$100.0$200.0$500.0$1.0K$2.0K$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
$56.23 / $2,454.71 / $5,011.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $812.83 / $1,819.70
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $724.44 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $1,513.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $851.14 / $1,412.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $933.25 / $1,412.54