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Arizona rates for HCPCS 15760

Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,582.00 / $3,161.50 / $6,483.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.51 / $783.47 / $1,407.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.35 / $2,283.06 / $3,616.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.22 / $671.22 / $812.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.49 / $801.64 / $1,445.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.36 / $818.89 / $3,093.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.60 / $859.86 / $6,301.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.00 / $2,567.00 / $5,105.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.00 / $809.28 / $1,254.59