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Nebraska 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 $4,365 · 10th–90th $1,148–$12,0230%10%10th90th$4,365Professionalmedian $1,202 · 10th–90th $631–$3,0200%10%10th90th$1,202$0.5$5.0$50.0$500.0$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
$1,148.15 / $4,365.16 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,071.52 / $3,235.94
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,365.16 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,148.15 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,862.09 / $2,454.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,445.44 / $6,165.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,737.80 / $6,309.57
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,949.84 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,862.09 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,370.32 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,479.11 / $1,949.84