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Nebraska 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 $2,754 · 10th–90th $135–$8,5110%10%10th90th$2,754Professionalmedian $162 · 10th–90th $62–$4270%5%10%10th90th$162$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
$138.04 / $3,630.78 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $162.18 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,365.16 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $125.89 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $213.80 / $371.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $169.82 / $1,230.27
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $275.42 / $1,513.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $239.88 / $389.05
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $162.18 / $309.03