go back

Washington 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

Facilitymedian $2,089 · 10th–90th $1,202$13,4900%10%20%10th90th$2,089Professionalmedian $1,096 · 10th–90th $692$2,3990%10%20%10th90th$1,096$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,454.71 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $977.24 / $2,398.83
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,897.79 / $10,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,513.56 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,122.02 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,513.56 / $2,630.27
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,737.80 / $2,951.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,737.80 / $2,511.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $338.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,778.28 / $1,862.09
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,230.27 / $1,288.25
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,479.11 / $2,344.23
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,011.87 / $10,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,548.82 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $6,456.54 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,230.27 / $2,290.87
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,071.52 / $1,479.11