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Kentucky 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
$128.82 / $1,513.56 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $173.78 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $181.97 / $181.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $2,344.23 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $158.49 / $234.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $151.36 / $177.83
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $165.96 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $213.80 / $954.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $602.56 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $186.21 / $288.40