go back

Texas 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
$789.00 / $3,060.00 / $10,048.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.15 / $824.73 / $1,284.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$848.95 / $876.05 / $1,357.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,444.24 / $2,580.16 / $5,456.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.95 / $921.40 / $1,312.72
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.30 / $2,852.16 / $5,586.44
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$680.79 / $766.55 / $904.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.59 / $1,023.48 / $1,540.86
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,489.16 / $26,542.00 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,798.24 / $6,747.84 / $7,852.73
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.89 / $932.36 / $1,327.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$907.97 / $1,285.73 / $1,688.82
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$745.49 / $932.91 / $1,191.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.75 / $927.24 / $1,359.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.90 / $1,066.79 / $1,700.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $2,064.00 / $4,554.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.19 / $957.46 / $1,456.30
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.93 / $876.05 / $1,226.47