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New York 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
$921.44 / $3,599.00 / $8,442.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.29 / $780.63 / $1,678.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,263.00 / $5,196.00 / $11,909.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.62 / $828.08 / $1,708.85
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,059.88 / $1,716.00 / $6,213.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.88 / $1,059.88 / $1,238.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,278.85 / $1,278.85 / $1,278.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.23 / $1,048.16 / $2,362.87
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $805.66 / $1,970.96
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,018.06 / $1,180.03 / $2,484.84
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.76 / $812.80 / $1,612.84
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $1,278.85 / $74,999.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.20 / $1,097.58 / $2,417.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,160.00 / $5,248.00 / $11,200.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.07 / $1,028.25 / $2,304.40
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$813.43 / $813.43 / $2,672.08
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.76 / $937.06 / $2,290.67