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Wyoming 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
Professional
Modifier
Low / Median / High Price
$68.91 / $69.15 / $130.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.00 / $193.00 / $304.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.83 / $146.83 / $246.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.26 / $231.61 / $417.93