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Idaho 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

Facilitymedian $1,622 · 10th–90th $708–$5,4950%10%10th90th$1,622Professionalmedian $1,047 · 10th–90th $617–$1,6220%10%10th90th$1,047$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $870.96 / $1,584.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $2,187.76 / $4,786.30
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,318.26 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,122.02 / $1,348.96
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,047.13 / $1,621.81
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $1,737.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,073.80 / $6,025.60
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,230.27 / $1,548.82
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $6,165.95 / $7,762.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,412.54