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Delaware 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
$3,949.00 / $3,949.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.87 / $79.62 / $116.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.34 / $95.73 / $188.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.52 / $142.29 / $311.52