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Florida 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
$668.00 / $3,401.00 / $10,632.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.25 / $799.87 / $1,226.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.20 / $816.93 / $816.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.00 / $977.92 / $1,164.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.49 / $883.47 / $1,427.91
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,144.00 / $5,731.00 / $11,037.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.44 / $706.53 / $1,082.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.53 / $676.58 / $1,061.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,014.00 / $3,611.00 / $8,105.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.46 / $861.71 / $1,497.09
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$615.08 / $716.70 / $716.70