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Iowa 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
$2,906.00 / $4,235.59 / $7,119.04
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.09 / $184.48 / $420.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.49 / $211.40 / $1,607.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.90 / $302.04 / $439.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,204.00 / $1,623.00 / $2,126.00