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Utah 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 $3,236 · 10th–90th $1,047–$6,0260%10%20%10th90th$3,236Professionalmedian $933 · 10th–90th $708–$2,1380%10%10th90th$933$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,047.13 / $3,235.94 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $912.01 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,230.27 / $1,584.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,511.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,548.13 / $5,495.41
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,288.25 / $1,737.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,230.27 / $1,862.09
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,258.93 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $933.25 / $1,412.54