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Nevada 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
$781.97 / $2,173.00 / $4,841.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.19 / $747.97 / $3,588.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,072.00 / $3,931.00 / $5,258.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.04 / $753.97 / $1,189.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,032.25 / $1,032.25 / $1,032.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.42 / $790.83 / $1,308.81
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.26 / $966.67 / $1,346.54
Hometown Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,021.63 / $2,021.63 / $2,021.63
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.27 / $783.76 / $1,278.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$727.12 / $2,200.00 / $3,658.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$751.36 / $824.29 / $1,438.94