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South Carolina rates for HCPCS 15200

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

Facilitymedian $6,761 · 10th–90th $813–$16,5960%10%10th90th$6,761Professionalmedian $759 · 10th–90th $575–$1,2020%10%20%10th90th$759$50.0$200.0$1.0K$5.0K$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
$912.01 / $8,709.64 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $758.58 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,715.35 / $6,606.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $758.58 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $851.14 / $1,288.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $870.96 / $1,230.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $10,000.00 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $741.31 / $1,148.15