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Hawaii 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

Facilitymedian $2,818 · 10th–90th $1,698–$4,4670%20%40%10th90th$2,818Professionalmedian $1,122 · 10th–90th $661–$5,3700%5%10%10th90th$1,122$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,818.38 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,202.26 / $1,445.44
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,584.89 / $7,943.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,096.48 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $1,288.25
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $2,691.53 / $6,165.95