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West Virginia 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
$808.18 / $6,594.10 / $27,951.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.22 / $807.84 / $1,205.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$763.73 / $916.48 / $998.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.57 / $887.57 / $887.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,336.65 / $1,336.65 / $1,336.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.54 / $1,035.50 / $2,381.16
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,530.70 / $7,530.70 / $7,530.70
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,142.73 / $1,142.73 / $1,142.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.69 / $1,031.95 / $1,393.29