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Alaska rates for HCPCS 15201

Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $7,079.46 / $14,125.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $125.89 / $660.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $144.54 / $660.69