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North Dakota 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
$137.34 / $210.60 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.80 / $175.95 / $210.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.98 / $371.83 / $472.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.82 / $376.41 / $629.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.34 / $210.60 / $412.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.18 / $386.35 / $2,266.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.11 / $363.99 / $549.26