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New Mexico rates for HCPCS 15200

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

Facilitymedian $1,549 · 10th–90th $851–$8,7100%10%10th90th$1,549Professionalmedian $933 · 10th–90th $631–$1,6980%10%10th90th$933$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
$933.25 / $1,380.38 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $2,089.30
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $5,623.41 / $8,912.51
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $912.01 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $933.25 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $144.54 / $1,202.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $870.96 / $1,380.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $6,606.93 / $8,912.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,071.52 / $1,445.44