go back

Indiana rates for HCPCS 15135

Dermal Autograft F/S/N/H/F/G/M/D Gt 1st 100

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.37 / $1,163.70 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.37 / $710.22 / $825.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,266.00 / $5,570.00 / $13,810.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$671.31 / $832.98 / $1,191.91
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$614.55 / $895.15 / $1,076.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.49 / $946.19 / $1,130.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,623.15 / $2,623.15 / $2,623.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.60 / $910.71 / $1,401.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.38 / $902.60 / $1,407.14