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Tennessee 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
$819.32 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.84 / $841.46 / $1,284.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,662.00 / $2,867.00 / $3,728.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.72 / $975.11 / $1,475.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$736.29 / $997.50 / $2,334.04
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,489.16 / $5,607.06 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,798.24 / $6,747.84 / $7,852.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,130.00 / $2,297.00 / $4,099.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$813.84 / $1,010.10 / $2,192.00