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Louisiana 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
$660.69 / $1,513.56 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $851.14 / $1,202.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $4,786.30 / $7,079.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $891.25 / $1,000.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $933.25 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $3,467.37 / $8,511.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $831.76 / $1,318.26