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New Hampshire rates for HCPCS 15200

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

Facilitymedian $2,754 · 10th–90th $1,622–$11,4820%20%10th90th$2,754Professionalmedian $933 · 10th–90th $603–$1,9950%10%10th90th$933$100.0$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
$2,290.87 / $2,754.23 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $741.31 / $1,698.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,047.13 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,000.00 / $2,041.74
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,258.93 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,174.90 / $2,454.71