go back

Massachusetts 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
$707.95 / $3,019.95 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $954.99 / $2,398.83
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $3,630.78 / $45,708.82
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,202.26 / $2,754.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $954.99 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,698.24 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,230.27 / $2,630.27
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,548.82 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,288.25 / $1,819.70
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,630.78 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,348.96 / $2,454.71
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $4,570.88 / $29,512.09
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,445.44 / $1,479.11
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $3,630.78 / $45,708.82
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,202.26 / $2,754.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,630.78 / $8,511.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,202.26 / $2,398.83