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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
$851.14 / $2,570.40 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $933.25 / $1,737.80
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $933.25 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $5,754.40 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,096.48 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,122.02 / $1,412.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,122.02 / $4,073.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,071.52 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,995.26 / $3,981.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $912.01 / $1,258.93