go back

North Dakota 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
$108.48 / $181.74 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.51 / $148.19 / $181.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.75 / $270.55 / $400.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.36 / $318.57 / $452.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.48 / $181.74 / $325.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.94 / $333.40 / $1,925.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.38 / $273.32 / $473.79