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Oregon 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 $245 · 10th–90th $102–$5,6230%10%10th90th$245Professionalmedian $132 · 10th–90th $62–$3160%5%10%10th90th$132$100.0$200.0$500.0$1.0K$2.0K$5.0K

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 / $288.40 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $117.49 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $177.83 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $141.25 / $323.59
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $165.96 / $316.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $218.78 / $309.03
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $257.04
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $151.36 / $288.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $169.82 / $323.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $213.80 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $177.83 / $331.13