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Missouri rates for HCPCS 15200

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

Facilitymedian $2,512 · 10th–90th $741–$5,6230%5%10th90th$2,512Professionalmedian $794 · 10th–90th $575–$2,1380%10%10th90th$794$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$741.31 / $3,311.31 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $758.58 / $2,187.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $812.83 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $870.96 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $933.25 / $1,513.56
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,174.90 / $11,748.98
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,096.48 / $6,165.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,398.83 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $831.76 / $1,318.26