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Nationwide rates for HCPCS 15121

Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $3,548 · 10th–90th $234–$10,0000%10%20%10th90th$3,548Professionalmedian $282 · 10th–90th $135–$5750%20%10th90th$282$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$251.19 / $3,890.45 / $10,471.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $4,265.80 / $12,022.64
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $741.31 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $1,174.90 / $3,630.78

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