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Oregon 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 $269 · 10th–90th $112–$5,1290%10%10th90th$269Professionalmedian $158 · 10th–90th $120–$3550%10%10th90th$158$100.0$200.0$500.0$1.0K$2.0K$5.0K

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 / $316.23 / $7,943.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $354.81
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $177.83 / $346.74
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $269.15 / $281.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $162.18 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95