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Tennessee 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
$357.92 / $2,303.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.43 / $162.38 / $238.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.00 / $150.00 / $2,367.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.97 / $203.46 / $325.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.82 / $200.87 / $401.62
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$610.08 / $661.68 / $16,394.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.00 / $2,266.96 / $2,266.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $786.00 / $2,577.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.92 / $227.70 / $416.87