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Connecticut rates for HCPCS 15261

Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.25 / $4,722.42 / $8,031.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.33 / $186.13 / $361.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,315.00 / $5,646.00 / $7,714.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.83 / $202.86 / $307.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.34 / $251.09 / $394.34
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.34 / $267.45 / $279.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.00 / $3,983.00 / $6,832.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.66 / $250.27 / $442.56