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New Jersey 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
$657.27 / $5,109.00 / $9,860.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.48 / $700.19 / $1,270.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$441.22 / $861.31 / $1,648.43
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$847.37 / $1,148.65 / $1,278.26
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,283.18 / $4,447.22 / $8,481.31
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.97 / $908.74 / $1,330.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,844.00 / $7,579.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.11 / $772.43 / $1,550.56