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Missouri 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 $2,239 · 10th–90th $302$5,6230%5%10th90th$2,239Professionalmedian $115 · 10th–90th $60$3160%10%10th90th$115$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
$114.82 / $3,162.28 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $112.20 / $407.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $120.23 / $199.53
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $131.83 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $169.82 / $16,218.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $707.95 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $117.49 / $190.55