go back

Alaska rates for HCPCS 15240

Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,618.19 / $10,175.36 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.22 / $942.01 / $4,417.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,382.12 / $1,603.92 / $2,979.63
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,827.85 / $5,358.99 / $6,184.47
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,948.08 / $2,337.69 / $2,723.91
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,925.56 / $3,367.78 / $4,002.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,827.85 / $5,358.99 / $6,184.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,355.59 / $2,732.15 / $5,264.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.14 / $2,383.69 / $3,596.06