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Texas 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 $2,818 · 10th–90th $195–$12,0230%5%10%10th90th$2,818$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
$812.83 / $3,467.37 / $12,022.64
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,238.72 / $6,456.54
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $213.80
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $45,708.82 / $45,708.82
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $281.84 / $4,073.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $208.93 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $954.99 / $2,290.87