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Michigan 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 $2,884 · 10th–90th $102–$4,8980%20%10th90th$2,884Professionalmedian $107 · 10th–90th $59–$2000%10%10th90th$107$20.0$100.0$500.0$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
$102.33 / $2,884.03 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $107.15 / $199.53
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $97.72 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $316.23
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $1,348.96 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $151.36 / $229.09
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $95.50 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,258.93 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $120.23 / $173.78