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North Carolina 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
$87.50 / $135.99 / $5,449.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.48 / $87.50 / $97.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.02 / $119.10 / $193.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.14 / $124.06 / $216.05
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.50 / $113.87 / $146.79
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.34 / $119.34 / $400.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.00 / $833.00 / $1,928.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.81 / $98.78 / $241.43
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.76 / $436.76 / $12,000.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.40 / $758.33 / $831.00