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Minnesota rates for HCPCS 15200

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

Facilitymedian $3,162 · 10th–90th $813–$7,4130%5%10th90th$3,162Professionalmedian $1,514 · 10th–90th $708–$2,8180%5%10%10th90th$1,514$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
$645.65 / $812.83 / $812.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $758.58 / $1,621.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,570.88 / $13,182.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,698.24 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,090.30 / $7,413.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,238.72 / $3,548.13
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,951.21 / $5,754.40
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,089.30 / $3,311.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,202.26 / $3,311.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,584.89 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $5,248.07 / $8,912.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,445.44 / $2,754.23