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North Dakota 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
$90.62 / $98.20 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.43 / $90.62 / $119.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.88 / $194.57 / $228.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.22 / $205.04 / $293.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.62 / $119.28 / $271.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.67 / $158.18 / $650.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,025.00 / $5,025.00 / $5,025.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.67 / $123.86 / $211.95