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Vermont 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
Professional
Modifier
Low / Median / High Price
$630.96 / $954.99 / $3,235.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,230.27 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,230.27 / $2,754.23
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,548.82 / $1,548.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,122.02 / $2,187.76