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Rhode Island 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 $2,089 · 10th–90th $537–$3,9810%10%10th90th$2,089Professionalmedian $107 · 10th–90th $52–$2190%10%10th90th$107$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,754.23 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $107.15 / $218.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $95.50 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $141.25 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,230.27 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $120.23 / $223.87