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Illinois 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)

Facilitymedian $1,862 · 10th–90th $151$5,8880%5%10th90th$1,862Professionalmedian $195 · 10th–90th $102$6760%5%10th90th$195$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$151.36 / $1,862.09 / $5,888.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $870.96 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $194.98 / $676.08
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $851.14 / $2,290.87