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Wyoming 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
Professional
Modifier
Low / Median / High Price
$869.57 / $898.20 / $1,032.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,494.00 / $1,992.00 / $2,366.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.56 / $1,304.13 / $1,816.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $5,606.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.24 / $1,738.50 / $2,850.11