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Vermont 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
Professional
Modifier
Low / Median / High Price
$87.10 / $144.54 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $186.21 / $501.19
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $288.40 / $288.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $208.93 / $426.58