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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
$838.00 / $3,165.00 / $8,400.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,878.46 / $6,117.46 / $9,735.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.52 / $146.56 / $1,582.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.00 / $610.00 / $1,883.00