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North Dakota 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 / $933.25 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $912.01 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,819.70 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,905.46 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,071.52 / $2,398.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,698.24 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $3,019.95 / $3,388.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,348.96 / $1,995.26