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Rhode Island 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
$2,089.30 / $2,754.23 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $190.55 / $812.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $158.49 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $229.09 / $446.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $1,412.54 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $218.78 / $389.05