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Connecticut 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 $4,898 · 10th–90th $263–$8,5110%10%20%10th90th$4,898Professionalmedian $117 · 10th–90th $62–$2820%10%10th90th$117$50.0$200.0$1.0K$5.0K

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
$263.03 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $117.49 / $295.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $5,370.32 / $7,943.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $120.23 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $144.54 / $275.42
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $177.83 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $3,981.07 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $123.03 / $251.19