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Rhode Island 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 $4,677 · 10th–90th $2,291–$8,5110%10%20%10th90th$4,677Professionalmedian $891 · 10th–90th $525–$1,8620%10%10th90th$891$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
$2,089.30 / $4,677.35 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $891.25 / $1,995.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $724.44 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,128.61 / $10,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,000.00 / $1,513.56