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Missouri 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
$1,071.52 / $3,162.28 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $812.83 / $2,187.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $891.25 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $912.01 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,047.13 / $1,659.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,288.25 / $16,218.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,174.90 / $6,456.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,019.95 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $891.25 / $1,479.11