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Illinois 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 $1,862 · 10th–90th $135–$5,8880%5%10th90th$1,862Professionalmedian $117 · 10th–90th $60–$2450%10%10th90th$117$20.0$100.0$500.0$2.0K$10.0K

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 / $1,862.09 / $5,888.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $114.82 / $263.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $776.25 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $131.83 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $223.87
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $177.83 / $537.03
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $173.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $851.14 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $128.82 / $234.42