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Michigan 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 $2,884 · 10th–90th $851–$6,0260%10%20%10th90th$2,884Professionalmedian $851 · 10th–90th $603–$1,6600%10%10th90th$851$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$851.14 / $2,884.03 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $831.76 / $1,737.80
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,047.13 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $3,235.94
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $2,570.40 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $977.24 / $1,621.81
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $794.33 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,888.44 / $10,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $912.01 / $1,258.93