go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$467.74 / $776.25 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,047.13 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $933.25 / $2,290.87
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,288.25 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $933.25 / $1,819.70