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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
$138.04 / $3,630.78 / $8,317.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $177.83 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $537.03 / $1,905.46