go back

Wyoming 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
$135.56 / $136.37 / $208.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.00 / $362.00 / $483.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.34 / $256.68 / $385.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.33 / $359.41 / $606.10