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Maryland 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 $2,455 · 10th–90th $129–$2,4550%50%10th$2,455Professionalmedian $269 · 10th–90th $214–$4370%20%10th90th$269$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $263.03 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $151.36