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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
$1,023.29 / $3,801.89 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $933.25 / $1,698.24
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $3,162.28 / $3,311.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,122.02 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,122.02 / $5,623.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,047.13 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,445.44 / $3,311.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $954.99 / $1,348.96