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Michigan rates for HCPCS 15260

Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less

Facilitymedian $2,754 · 10th–90th $977–$4,8980%10%20%10th90th$2,754Professionalmedian $1,072 · 10th–90th $724–$2,2390%20%10th90th$1,072$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $2,754.23 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,000.00 / $2,344.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $1,288.25 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,000.00 / $4,073.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $2,884.03 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $1,995.26
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $933.25 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,235.94 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,023.29 / $1,412.54