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Illinois rates for HCPCS 15130

Dermal Autograft Trunk/Arm/Leg 1st 100 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$674.78 / $1,630.00 / $5,091.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.01 / $616.30 / $1,184.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,469.76 / $5,463.41 / $11,916.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.84 / $837.80 / $1,266.28
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$667.21 / $1,088.74 / $2,382.08
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.68 / $751.13 / $985.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,137.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,600.00 / $3,951.00 / $6,625.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.62 / $876.97 / $1,524.15