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Colorado 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
$1,248.00 / $4,955.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.16 / $109.47 / $130.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.27 / $138.27 / $237.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.52 / $122.91 / $197.09
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.73 / $118.39 / $191.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.63 / $132.46 / $250.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.00 / $1,464.00 / $3,011.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.96 / $177.57 / $283.57