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North Carolina 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 $209 · 10th–90th $68–$6,7610%5%10%10th90th$209Professionalmedian $120 · 10th–90th $62–$2820%10%10th90th$120$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$67.61 / $501.19 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $117.49 / $281.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $158.49 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $131.83 / $257.04
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $218.78
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $114.82 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $831.76 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $208.93
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $28,840.32
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89