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Minnesota 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
$776.25 / $5,623.41 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $891.25 / $1,995.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $4,897.79 / $13,182.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,905.46 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $3,467.37 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,630.27 / $4,073.80
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $3,311.31 / $6,456.54
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,344.23 / $3,715.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $1,479.11 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,737.80 / $5,888.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,548.13 / $6,760.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,584.89 / $3,090.30