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New York 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 $3,715 · 10th–90th $166–$8,5110%10%10th90th$3,715$50.0$200.0$1.0K$5.0K$20.0K

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
$123.03 / $3,090.30 / $7,762.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,772.37
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $1,698.24 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $1,659.59 / $53,703.18
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $102.33 / $251.19
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,511.89 / $4,897.79
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $81.28 / $288.40