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Washington, DC 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 $4,074 · 10th–90th $135–$5,8880%20%10th90th$4,074Professionalmedian $117 · 10th–90th $60–$2190%10%10th90th$117$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$134.90 / $4,073.80 / $5,888.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $117.49 / $218.78
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $77.62 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $223.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $181.97 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $549.54 / $5,888.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $120.23 / $199.53