go back

Vermont 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
$10,471.29 / $10,471.29 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,174.90 / $3,467.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,318.26 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,318.26 / $2,951.21
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,202.26 / $2,344.23