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New Jersey 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $5,888.44 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $112.20 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $123.03 / $239.88
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $194.98 / $218.78
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $134.90 / $234.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $3,019.95 / $7,762.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $87.10 / $218.78