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Idaho 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
$2,897.00 / $4,500.00 / $7,761.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.51 / $160.43 / $264.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.87 / $193.73 / $286.98
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.14 / $182.89 / $301.63
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.26 / $257.92 / $335.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $268.58
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.55 / $213.95 / $322.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.80 / $243.45 / $310.79