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Louisiana 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 $1,479 · 10th–90th $145–$3,8900%10%10th90th$1,479Professionalmedian $107 · 10th–90th $62–$1740%10%20%10th90th$107$0.0$0.2$2.0$20.0$200.0$2.0K

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
$389.05 / $1,513.56 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $107.15 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $912.01 / $1,584.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $154.88
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $107.15 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $562.34 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $112.20 / $173.78