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New Jersey 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
$2,398.83 / $5,623.41 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $831.76 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $912.01 / $1,819.70
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,258.93 / $1,412.54
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $11,748.98 / $18,620.87
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $977.24 / $1,698.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $7,585.78 / $15,135.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $660.69 / $1,513.56