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Mississippi 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
$602.56 / $1,288.25 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $660.69 / $1,122.02
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $851.14 / $1,230.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,621.81 / $4,073.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $741.31 / $1,230.27