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Delaware rates for HCPCS 15200

Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,504.73 / $1,897.99 / $8,249.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$585.50 / $738.52 / $738.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.75 / $727.53 / $1,034.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,039.07 / $13,039.07 / $13,039.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.74 / $820.33 / $1,929.20