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Vermont 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)

Professionalmedian $151 · 10th–90th $71–$3160%10%10th90th$151$100.0$200.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $151.36 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $134.90 / $309.03
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $213.80 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $158.49 / $302.00