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West Virginia 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
$143.09 / $156.05 / $1,400.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.24 / $167.09 / $182.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.08 / $235.08 / $235.08