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Rhode Island 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
$2,089.30 / $2,754.23 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $851.14 / $2,238.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $776.25 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,096.48 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $5,128.61 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,071.52 / $1,659.59