go back

California 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)

Facilitymedian $4,571 · 10th–90th $1,175–$13,4900%10%10th90th$4,571Professionalmedian $126 · 10th–90th $62–$4070%10%10th90th$126$20.0$100.0$500.0$2.0K$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
$2,137.96 / $6,309.57 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $120.23 / $501.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,466.84 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $138.04 / $316.23
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $4,786.30 / $9,120.11
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $144.54 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $128.82 / $229.09
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $112.20 / $204.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $134.90 / $263.03
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $28,840.32 / $28,840.32
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $181.97
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $117.49 / $208.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $131.83 / $251.19
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $446.68
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $154.88 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,584.89 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $114.82 / $234.42