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Oklahoma 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
$933.25 / $3,801.89 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $851.14 / $1,412.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $616.60 / $616.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $5,754.40 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,000.00 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,047.13 / $1,318.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,047.13 / $4,168.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,000.00 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,995.26 / $3,981.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $831.76 / $1,202.26