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Pennsylvania 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 $3,715 · 10th–90th $832–$8,3180%5%10th90th$3,715Professionalmedian $692 · 10th–90th $525–$1,3490%10%10th90th$692$200.0$1.0K$5.0K$20.0K

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
$831.76 / $3,715.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $676.08 / $1,348.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,466.84 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,148.15 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $758.58 / $1,202.26
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,202.26 / $1,348.96
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $891.25 / $1,318.26
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,951.21 / $9,772.37
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $776.25 / $1,047.13
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $691.83 / $1,412.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,318.26 / $3,090.30
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $616.60 / $758.58
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $588.84 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $3,162.28 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $741.31 / $1,318.26