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New Mexico 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
$1,071.52 / $1,479.11 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $912.01 / $1,862.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $5,754.40 / $9,120.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,096.48 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,148.15 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $263.03 / $1,318.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,047.13 / $1,380.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,174.90 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $4,265.80 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,258.93 / $1,584.89