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North Dakota 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 $851 · 10th–90th $661–$8,5110%20%10th90th$851Professionalmedian $1,047 · 10th–90th $661–$1,8200%10%10th90th$1,047$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
$660.69 / $851.14 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $812.83 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,621.81 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,621.81 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,023.29 / $2,884.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,548.82 / $6,309.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $5,128.61 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,174.90 / $1,862.09