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Delaware 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
$691.83 / $1,778.28 / $23,988.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,071.52 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $870.96 / $1,348.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $6,165.95 / $6,165.95
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $870.96 / $1,819.70