go back

Nebraska 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
$1,819.70 / $5,011.87 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $891.25 / $4,168.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $4,365.16 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,258.93 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,778.28 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,412.54 / $6,165.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,778.28 / $6,456.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,949.84 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,905.46 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $5,495.41 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,548.82 / $2,089.30