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Colorado rates for HCPCS 15115

Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,226.00 / $4,955.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$609.71 / $712.76 / $997.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,434.00 / $5,126.00 / $9,729.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.33 / $1,013.75 / $1,559.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$769.07 / $945.20 / $1,245.70
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.25 / $968.80 / $1,217.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$805.43 / $1,071.22 / $1,594.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,349.00 / $3,397.00 / $6,686.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$854.76 / $1,071.58 / $1,689.47