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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
$107.17 / $178.66 / $290.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.41 / $185.40 / $498.40
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.97 / $252.61 / $498.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.29 / $245.78 / $429.27