go back

Louisiana rates for HCPCS 15050

Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.00 / $1,520.00 / $3,685.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.45 / $560.97 / $705.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$492.50 / $1,005.84 / $1,512.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.17 / $637.77 / $707.92
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.63 / $552.83 / $803.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.00 / $513.00 / $1,226.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.02 / $574.96 / $1,002.73