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Hawaii 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)

Facilitymedian $3,890 · 10th–90th $1,148–$3,8900%50%10th$3,890Professionalmedian $186 · 10th–90th $115–$3090%10%10th90th$186$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$1,513.56 / $3,890.45 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $263.03 / $316.23
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $269.15 / $309.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $218.78 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $218.78 / $269.15
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $169.82 / $251.19