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Washington, DC rates for HCPCS 15241

Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.27 / $2,080.00 / $6,456.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.81 / $159.32 / $183.31
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.86 / $120.86 / $2,298.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.60 / $166.50 / $351.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.69 / $404.32 / $481.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.00 / $442.00 / $5,940.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.38 / $212.93 / $521.47