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Kentucky 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
$741.31 / $1,412.54 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $851.14 / $1,548.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $758.58 / $977.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,801.89 / $8,511.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $691.83 / $977.24
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $891.25 / $1,047.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $977.24 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,348.96 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,023.29 / $4,365.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $1,445.44 / $5,248.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $870.96 / $1,412.54