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Iowa 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 $1,950 · 10th–90th $135–$6,0260%10%10th90th$1,950Professionalmedian $123 · 10th–90th $62–$3800%5%10%10th90th$123$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
$134.90 / $3,019.95 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $120.23 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $371.54
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $154.88 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $234.42 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $213.80 / $1,380.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $275.42 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,621.81 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $144.54 / $309.03
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $144.54 / $263.03