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Florida 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
$615.24 / $3,401.00 / $10,802.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.05 / $691.88 / $946.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $977.92 / $1,164.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.35 / $795.08 / $1,243.98
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,144.00 / $5,731.00 / $11,037.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.25 / $637.05 / $959.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.98 / $592.83 / $938.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,014.00 / $3,611.00 / $6,730.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.27 / $758.27 / $1,285.96
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.52 / $625.54 / $625.54