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Wyoming 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
$0.88 / $0.88 / $0.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.92 / $818.92 / $958.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,410.00 / $1,880.00 / $2,201.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.06 / $1,227.00 / $1,677.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $5,606.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.18 / $1,618.34 / $2,872.38