go back

Kansas rates for HCPCS 15220

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$873.95 / $3,701.00 / $10,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.21 / $759.33 / $1,040.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.00 / $348.45 / $732.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.46 / $835.83 / $1,031.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.00 / $442.00 / $442.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.66 / $899.28 / $1,283.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.84 / $883.08 / $4,294.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$760.18 / $910.11 / $5,728.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$909.00 / $2,081.00 / $3,842.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.59 / $848.78 / $1,296.93