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New York 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 $4,074 · 10th–90th $1,023$10,0000%5%10th90th$4,074Professionalmedian $871 · 10th–90th $603$2,1880%10%10th90th$871$100.0$500.0$2.0K$10.0K$50.0K

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
$954.99 / $3,311.31 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $831.76 / $2,290.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,495.41 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $870.96 / $1,949.84
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,698.24 / $6,165.95
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $4,786.30 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,071.52 / $2,344.23
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $812.83 / $2,398.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,230.27 / $1,905.46
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $912.01 / $1,548.82
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $5,370.32 / $11,748.98
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,000.00 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $4,897.79 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $912.01 / $2,187.76
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $741.31 / $2,570.40
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $977.24 / $2,290.87