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Indiana 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 $8,128 · 10th–90th $1,122–$11,2200%10%10th90th$8,128Professionalmedian $933 · 10th–90th $661–$2,0420%10%10th90th$933$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$891.25 / $4,897.79 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $2,238.72
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $977.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $8,317.64 / $10,471.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $933.25 / $1,445.44
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $912.01 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $912.01 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,715.35 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $1,412.54