go back

Kentucky 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
$631.54 / $826.83 / $5,320.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.54 / $750.76 / $903.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,359.00 / $2,292.00 / $4,229.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.22 / $754.81 / $1,059.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$708.94 / $863.23 / $1,007.79
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.26 / $979.99 / $1,580.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,278.85 / $1,278.85 / $1,587.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$687.41 / $875.47 / $1,560.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,027.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$739.00 / $2,194.00 / $8,174.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.08 / $902.60 / $1,471.54