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New Hampshire 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 $2,818 · 10th–90th $1,698–$11,4820%10%10th90th$2,818Professionalmedian $1,122 · 10th–90th $708–$2,2390%10%10th90th$1,122$100.0$200.0$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
$2,398.83 / $2,818.38 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $891.25 / $2,238.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,202.26 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,174.90 / $2,290.87
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,445.44 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,318.26 / $2,818.38