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Indiana rates for HCPCS 15130

Dermal Autograft Trunk/Arm/Leg 1st 100 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$492.75 / $927.00 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.75 / $560.82 / $674.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,234.00 / $5,126.00 / $8,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.81 / $629.73 / $924.18
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$482.66 / $703.03 / $881.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.36 / $775.63 / $926.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,314.83 / $1,314.83 / $1,314.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.83 / $747.89 / $1,100.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,094.00 / $10,413.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.41 / $736.44 / $1,163.03