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South Carolina 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
$186.21 / $8,709.64 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $147.91 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $1,096.48 / $1,862.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $181.97 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $165.96 / $245.47
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $169.82 / $251.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $1,202.26 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $151.36 / $251.19