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Tennessee 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
$201.08 / $2,303.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.00 / $150.00 / $1,959.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.15 / $368.08 / $16,394.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $786.00 / $2,577.00