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Michigan rates for HCPCS 15200

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

Facilitymedian $4,074 · 10th–90th $977–$5,4950%20%10th90th$4,074Professionalmedian $813 · 10th–90th $575–$1,4130%10%10th90th$813$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 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $794.33 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $954.99 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $794.33 / $3,162.28
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $4,073.80 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $977.24 / $1,659.59
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $758.58 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,981.07 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $831.76 / $1,122.02