go back

Alaska rates for HCPCS 15135

Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,193.34 / $7,340.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,700.64 / $3,980.51 / $4,227.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.76 / $1,453.44 / $2,837.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.64 / $5,180.89 / $5,918.43
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,851.03 / $2,221.23 / $2,546.31
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,829.77 / $3,144.70 / $3,678.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.64 / $5,180.89 / $5,918.43
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.76 / $2,596.48 / $4,864.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.37 / $2,269.90 / $3,424.38