go back

New York 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
$172.37 / $2,920.00 / $7,563.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,691.00 / $3,382.00 / $4,707.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.61 / $1,254.00 / $4,050.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.08 / $235.08 / $14,648.00
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.00 / $209.50 / $365.11
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.08 / $555.00 / $74,999.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$964.00 / $2,826.00 / $4,851.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.88 / $145.88 / $539.91