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Montana 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 $1,698 · 10th–90th $1,318–$2,0890%20%40%10th90th$1,698Professionalmedian $1,023 · 10th–90th $724–$1,9050%20%10th90th$1,023$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $2,137.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,348.96 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,318.26 / $1,659.59
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,698.24 / $1,862.09
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,698.24 / $1,862.09
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,698.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,318.26 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,513.56 / $1,819.70