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New Hampshire 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 $3,020 · 10th–90th $1,738–$8,1280%10%10th90th$3,020Professionalmedian $1,230 · 10th–90th $759–$2,5120%5%10%10th90th$1,230$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$2,089.30 / $3,019.95 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $977.24 / $2,454.71
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $3,388.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,288.25 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,258.93 / $2,454.71
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,513.56 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,412.54 / $2,951.21