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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
$89.42 / $5,109.00 / $9,860.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.89 / $107.95 / $221.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.13 / $105.74 / $209.10
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.77 / $179.97 / $202.03
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.70 / $134.21 / $204.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,529.00 / $3,352.00 / $10,536.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.73 / $134.21 / $265.31