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Hawaii 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)

Facilitymedian $2,818 · 10th–90th $871–$4,4670%20%40%10th90th$2,818Professionalmedian $158 · 10th–90th $93–$4270%10%10th90th$158$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,818.38 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $158.49 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $223.87 / $269.15
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $263.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $199.53 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $234.42
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $128.82 / $213.80