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Ohio 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
$133.94 / $2,113.00 / $10,268.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$711.00 / $2,059.00 / $2,550.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.72 / $194.73 / $194.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.00 / $975.00 / $2,914.00