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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
$795.77 / $932.55 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$736.30 / $809.94 / $1,129.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,583.98 / $1,845.67 / $2,171.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,325.94 / $1,975.57 / $2,899.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$795.77 / $1,058.93 / $2,387.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$957.46 / $1,710.76 / $6,925.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.87 / $1,463.84 / $2,177.57