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Kentucky 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 $2,291 · 10th–90th $537–$4,3650%10%10th90th$2,291Professionalmedian $107 · 10th–90th $56–$1820%10%10th90th$107$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$64.57 / $1,288.25 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $107.15 / $194.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,344.23 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $89.13 / $134.90
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $77.62 / $91.20
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $85.11 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $117.49 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $128.82 / $588.84
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
$58.88 / $724.44 / $1,949.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $114.82 / $181.97