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Maine 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 $1,549 · 10th–90th $1,122–$12,0230%20%10th90th$1,549Professionalmedian $794 · 10th–90th $537–$1,4790%10%10th90th$794$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,122.02 / $1,548.82 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $741.31 / $1,380.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $891.25 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $954.99 / $1,737.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $977.24 / $1,513.56
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $676.08 / $1,348.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,000.00 / $1,737.80