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Vermont 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
Professional
Modifier
Low / Median / High Price
$138.49 / $212.04 / $366.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.61 / $218.91 / $592.24
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.27 / $297.38 / $592.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.81 / $297.70 / $916.11