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Oklahoma 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
$994.21 / $3,021.00 / $8,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.11 / $927.91 / $994.21
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,226.89 / $1,226.89 / $1,226.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,878.46 / $6,161.50 / $9,789.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.85 / $1,111.45 / $1,294.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.00 / $1,117.83 / $1,415.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.13 / $1,132.55 / $4,012.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.70 / $1,028.55 / $7,470.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.00 / $1,928.00 / $3,790.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.84 / $1,028.55 / $1,496.20