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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
$891.25 / $2,454.71 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $891.25 / $2,041.74
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $933.25 / $1,479.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,951.21 / $3,981.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,023.29 / $2,041.74
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,623.41 / $5,623.41 / $45,708.82
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,760.83 / $7,943.28 / $7,943.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $2,290.87 / $4,073.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $933.25 / $1,621.81