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Idaho 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 $646 · 10th–90th $93–$5,4950%10%10th90th$646Professionalmedian $120 · 10th–90th $65–$2570%5%10%10th90th$120$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
$1,621.81 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $117.49 / $269.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $467.74 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $125.89 / $223.87
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $134.90 / $275.42
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $181.97 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $144.54 / $245.47
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $8,317.64 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $134.90 / $229.09