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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
$109.65 / $169.82 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $218.78 / $588.84
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $338.84 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $257.04 / $501.19