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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
$780.65 / $3,214.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.98 / $754.63 / $1,279.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,958.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.27 / $859.97 / $1,352.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$723.11 / $1,043.39 / $1,726.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$651.05 / $1,152.53 / $11,536.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$747.65 / $1,121.05 / $6,484.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.00 / $3,502.00 / $6,854.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.95 / $933.26 / $1,751.26