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Pennsylvania rates for HCPCS 15241

Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $4,266 · 10th–90th $724–$8,3180%10%10th90th$4,266Professionalmedian $151 · 10th–90th $91–$2950%10%20%10th90th$151$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$831.76 / $4,265.80 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $281.84
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $165.96 / $281.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $309.03
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $213.80 / $302.00
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $3,630.78 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $346.74
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $316.23 / $741.31
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $169.82 / $478.63
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $169.82 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $575.44 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $269.15