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New York 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 $4,571 · 10th–90th $251–$10,9650%5%10th90th$4,571$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
$208.93 / $3,890.45 / $9,332.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,495.41 / $12,882.50
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $1,995.26 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $3,235.94 / $53,703.18
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $467.74
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,511.89 / $4,897.79
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $660.69