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Iowa rates for HCPCS 15116

Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,218.00 / $3,576.15 / $7,119.04
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.76 / $227.85 / $454.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.83 / $308.45 / $1,607.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.00 / $347.08 / $503.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,204.00 / $1,623.00 / $2,126.00