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Idaho 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
$1,621.81 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $977.24 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $3,630.78 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,479.11 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,096.48 / $1,412.54
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,096.48 / $1,513.56
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,412.54 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $8,128.31 / $11,220.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,445.44 / $1,819.70
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,148.15 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $16,982.44 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,096.48 / $1,479.11