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Delaware rates for HCPCS 15130

Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,949.00 / $3,949.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.78 / $521.78 / $639.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.27 / $643.32 / $914.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.39 / $756.18 / $1,663.60