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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$641.82 / $815.48 / $4,828.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.82 / $815.48 / $1,258.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,370.01 / $3,994.29 / $7,374.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,097.86 / $1,690.16 / $2,881.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,066.07 / $2,929.95 / $7,048.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,289.10 / $2,226.67 / $3,537.86
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,679.57 / $2,678.68 / $5,549.91
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,235.65 / $1,998.24 / $3,325.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$728.59 / $1,199.38 / $2,495.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$949.98 / $1,647.66 / $4,970.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,735.00 / $4,974.00 / $8,812.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.12 / $1,468.15 / $3,152.21