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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
$0.87 / $0.87 / $0.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $954.99 / $2,089.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,862.09 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,148.15 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,584.89 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,412.54 / $2,691.53