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Pennsylvania 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 $3,802 · 10th–90th $832–$8,3180%5%10%10th90th$3,802Professionalmedian $178 · 10th–90th $117–$4070%10%10th90th$178$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
$954.99 / $3,890.45 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $173.78 / $512.86
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,466.84 / $57,543.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $199.53 / $338.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $323.59 / $354.81
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $245.47 / $346.74
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $407.38
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $371.54 / $851.14
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $407.38
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $213.80 / $407.38
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
$120.23 / $194.98 / $331.13