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Kansas rates for HCPCS 15201

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.90 / $3,701.00 / $10,439.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.00 / $442.00 / $442.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.02 / $171.67 / $2,819.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.00 / $550.00 / $1,769.00