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Washington, DC 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
$1,698.24 / $3,090.30 / $5,011.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $851.14 / $2,238.72
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $2,238.72 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $933.25 / $2,041.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,905.46 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $8,128.31 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $891.25 / $2,041.74