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Indiana 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 $2,344 · 10th–90th $93–$7,2440%5%10%10th90th$2,344Professionalmedian $107 · 10th–90th $58–$2190%10%10th90th$107$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
$93.33 / $4,897.79 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $107.15 / $245.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $2,344.23 / $5,128.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $117.49 / $194.98
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $93.33 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $109.65 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,290.87 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $107.15 / $194.98