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Kansas 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
$1,122.44 / $4,376.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$678.06 / $925.60 / $1,257.97
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,037.33 / $1,037.33 / $1,037.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.00 / $732.01 / $3,312.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$925.72 / $1,089.08 / $1,251.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.00 / $505.00 / $505.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$771.34 / $1,157.10 / $1,547.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$766.21 / $1,071.57 / $4,330.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.84 / $1,101.18 / $6,925.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.00 / $2,081.00 / $3,918.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.51 / $960.07 / $1,413.45