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Illinois 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
$851.14 / $2,344.23 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $977.24 / $2,041.74
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $870.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $3,235.94 / $14,454.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,122.02 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,096.48 / $1,737.80
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,318.26 / $3,235.94
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,000.00 / $1,258.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $2,290.87 / $4,897.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,023.29 / $1,778.28