go back

New Mexico 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 $447 · 10th–90th $91–$5,0120%10%10th90th$447Professionalmedian $123 · 10th–90th $66–$2340%5%10%10th90th$123$20.0$100.0$500.0$2.0K

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
$91.20 / $208.93 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $120.23 / $316.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,621.81 / $2,511.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $125.89 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $123.03 / $208.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $181.97
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $123.03 / $229.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $134.90 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $1,148.15 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $234.42