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Nebraska 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $2,344.23 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,348.96 / $2,290.87
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $977.24 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,365.16 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,412.54 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $2,238.72 / $2,951.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,621.81 / $3,715.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,041.74 / $7,413.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,290.87 / $2,884.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,238.72 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,162.28 / $8,128.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,737.80 / $2,344.23