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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
$1,000.00 / $3,779.00 / $12,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$736.31 / $856.38 / $1,123.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,136.89 / $1,136.89 / $1,136.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,878.46 / $6,161.50 / $9,789.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$749.70 / $1,029.45 / $1,243.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$824.13 / $1,035.83 / $1,316.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$745.97 / $1,055.18 / $4,132.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.69 / $966.27 / $6,925.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.00 / $1,928.00 / $3,790.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$765.97 / $957.46 / $1,389.65