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South Carolina 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
$954.99 / $6,025.60 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $794.33 / $1,096.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,715.35 / $6,606.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $870.96 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $933.25 / $1,258.93
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $1,348.96
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $912.01 / $1,258.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $13,182.57 / $23,442.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $794.33 / $1,380.38