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Wyoming 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
$106.94 / $106.94 / $176.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.00 / $300.00 / $411.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.83 / $209.46 / $333.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.29 / $315.97 / $516.99