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Maine rates for HCPCS 15200

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

Facilitymedian $3,020 · 10th–90th $3,020–$3,0200%50%100%$3,020Professionalmedian $912 · 10th–90th $589–$1,6980%10%10th90th$912$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $851.14 / $1,698.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $977.24 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,023.29 / $1,905.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,096.48 / $1,698.24
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $724.44 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,096.48 / $1,862.09