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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
$824.31 / $4,230.00 / $9,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$736.96 / $824.31 / $1,179.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,054.52 / $3,883.00 / $6,494.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$702.22 / $826.00 / $1,260.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,200.28 / $3,200.28 / $3,200.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$709.40 / $929.76 / $1,248.03
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.96 / $904.33 / $1,252.71
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,872.87 / $2,872.87 / $2,872.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $580.78 / $956.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $12,798.00 / $19,665.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.95 / $839.44 / $1,385.08