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Louisiana rates for HCPCS 15200

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

Facilitymedian $2,188 · 10th–90th $759–$4,8980%5%10th90th$2,188Professionalmedian $813 · 10th–90th $562–$1,2020%10%20%10th90th$813$50.0$200.0$1.0K$5.0K

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
$758.58 / $1,905.46 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,202.26
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,311.31 / $5,248.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,000.00
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $870.96 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $2,511.89 / $5,888.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $776.25 / $1,230.27