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Maine 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 $3,467 · 10th–90th $3,090–$7,9430%20%40%10th90th$3,467Professionalmedian $1,000 · 10th–90th $692–$1,7780%10%10th90th$1,000$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
$3,090.30 / $3,467.37 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $954.99 / $1,778.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,122.02 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,148.15 / $2,089.30
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,148.15 / $1,905.46
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $851.14 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,230.27 / $2,041.74