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Maryland rates for HCPCS 15261

Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Facilitymedian $151 · 10th–90th $129–$1510%50%10th$151Professionalmedian $174 · 10th–90th $117–$3550%10%10th90th$174$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $354.81
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $144.54 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $245.47 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $186.21 / $331.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $218.78 / $338.84