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Minnesota 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
$575.44 / $707.95 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $616.60 / $1,122.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $4,466.84 / $12,302.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,445.44 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,630.27 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,995.26 / $3,090.30
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,511.89 / $5,011.87
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,778.28 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,096.48 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,288.25 / $4,365.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,248.07 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,148.15 / $2,344.23