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Hawaii rates for HCPCS 15220

Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less

Facilitymedian $3,890 · 10th–90th $1,514–$3,8900%50%10th$3,890Professionalmedian $1,023 · 10th–90th $537–$4,8980%5%10%10th90th$1,023$50.0$200.0$1.0K$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
$1,513.56 / $3,890.45 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $707.95 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,000.00 / $1,202.26
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $7,413.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $912.01 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $831.76 / $1,000.00
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $2,041.74 / $5,370.32