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Mississippi rates for HCPCS 15120

Split-thickness 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 (except 15050)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,318.26 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $794.33 / $1,288.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $977.24 / $1,513.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $3,235.94 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $812.83 / $1,479.11