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Maryland 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 $1,413 · 10th–90th $129–$2,8840%20%40%10th90th$1,413Professionalmedian $178 · 10th–90th $145–$3020%20%10th90th$178$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,884.03 / $2,884.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $177.83 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $151.36