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Tennessee 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
$178.94 / $2,133.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.41 / $95.14 / $114.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $150.00 / $1,676.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.61 / $102.14 / $157.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.53 / $111.78 / $261.63
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.21 / $436.76 / $12,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.40 / $758.33 / $831.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $786.00 / $2,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.74 / $109.17 / $198.71