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Rhode Island 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
$1,826.74 / $3,243.94 / $7,625.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.52 / $799.87 / $978.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.64 / $976.50 / $1,390.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.74 / $1,056.55 / $1,908.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,812.00 / $4,049.00 / $5,510.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$701.59 / $1,043.53 / $1,756.62