go back

Arkansas rates for HCPCS 15221

Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.83 / $1,074.00 / $3,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.39 / $108.40 / $144.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.30 / $100.44 / $168.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.90 / $447.90 / $447.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.95 / $110.06 / $186.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $330.00 / $768.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.45 / $139.31 / $241.74