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Tennessee 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
$277.12 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.50 / $138.06 / $200.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.00 / $147.00 / $2,367.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.21 / $166.64 / $271.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.03 / $169.36 / $330.55
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$482.93 / $519.32 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,775.00 / $1,925.20 / $1,925.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $786.00 / $2,577.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.25 / $200.03 / $357.07