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Indiana rates for HCPCS 15200

Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less

Facilitymedian $8,128 · 10th–90th $1,413–$11,2200%10%10th90th$8,128Professionalmedian $724 · 10th–90th $550–$1,4450%10%10th90th$724$200.0$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
$977.24 / $4,897.79 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $724.44 / $1,584.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $8,317.64 / $10,471.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $812.83 / $1,230.27
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $776.25 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $776.25 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $6,025.60 / $14,125.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $776.25 / $1,258.93