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Idaho rates for HCPCS 15131

Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,407.00 / $4,500.00 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.41 / $124.71 / $147.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.05 / $132.87 / $159.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.31 / $132.80 / $160.72
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.57 / $166.99 / $190.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $152.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.35 / $148.85 / $180.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.00 / $128.71 / $171.61