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Delaware 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
$4,736.00 / $4,736.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.18 / $96.51 / $159.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.87 / $150.50 / $243.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.86 / $189.88 / $417.74