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Oklahoma 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
$794.33 / $2,570.40 / $6,606.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $5,754.40 / $9,332.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $147.91 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $630.96 / $1,659.59