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Ohio 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 $3,715 · 10th–90th $977$10,7150%10%10th90th$3,715Professionalmedian $977 · 10th–90th $692$2,0420%20%10th90th$977$1.0$5.0$20.0$100.0$500.0$2.0K$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
$977.24 / $4,168.69 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,023.29 / $2,344.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,818.38 / $7,943.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $1,445.44
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $1,819.70
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $16,982.44 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $1,698.24
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $478.63
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $1,258.93
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $977.24 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,570.40 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $891.25 / $1,479.11