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Missouri rates for HCPCS 15130

Dermal Autograft Trunk/Arm/Leg 1st 100 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$639.75 / $3,214.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.93 / $618.42 / $910.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,958.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.91 / $659.62 / $1,047.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.53 / $810.88 / $1,364.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.87 / $949.97 / $7,354.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.24 / $911.93 / $5,312.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,438.00 / $2,874.00 / $5,813.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.95 / $755.29 / $1,397.93