go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$537.03 / $812.83 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,023.29 / $2,454.71
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,380.38 / $1,380.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $977.24 / $1,995.26